Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05726 | Date 10/07/2019 |
| Token No | SM/19-20/6238 10/07/2019 | Serial | 106 Last Visit: 10/07/2019 |
| Patient Name | Mrs. SARMILA KARMAKAR | Contact No | 8482028038 |
| Address | CHATRA LANKAR BAGAN | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 96 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||