Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05935 | Date 24/07/2019 |
| Token No | SM/19-20/7231 24/07/2019 | Serial | 073 Last Visit: 19/08/2019 |
| Patient Name | Mrs. MAMATA PAL | Contact No | 8420909705 |
| Address | CHATRA KUMAR PARA GARGARI GHAT | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||