Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05747 | Date 13/07/2019 |
| Token No | SM/19-20/6774 18/07/2019 | Serial | 049 Last Visit: 18/07/2019 |
| Patient Name | Miss MAUMITA PAL | Contact No | 9836304972 |
| Address | 84 A POTUA PARA LANE | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||