Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05787 | Date 15/07/2019 |
| Token No | SM/19-20/6541 15/07/2019 | Serial | 084 Last Visit: 17/07/2019 |
| Patient Name | Mrs. SARASWATI DAS | Contact No | 6304009486 |
| Address | MUSAT NANDAN PARA KALITALA | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||