Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04666 | Date 11/04/2019 |
| Token No | SM/19-20/717 11/04/2019 | Serial | 024 Last Visit: 11/04/2019 |
| Patient Name | Mrs. REKHA MONDAL | Contact No | 9088139359 |
| Address | RISHRA PANCHANAN TALA | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||