Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00184 | Date 07/08/2018 |
| Token No | SM/19-20/6908 20/07/2019 | Serial | 011 Last Visit: 11/06/2020 |
| Patient Name | Mrs. SHANKARI DAS | Contact No | 9330534335 |
| Address | 18 RAJA K.L. GOSWAMI STREET | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||