Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05758 | Date 13/07/2019 |
| Token No | SM/19-20/6411 13/07/2019 | Serial | 075 Last Visit: 13/07/2019 |
| Patient Name | Mrs. TAPASI DALAL | Contact No | 8697359394 |
| Address | 81 CHATRA BARUIPARA LANE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||