Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06053 | Date 05/08/2019 |
| Token No | SM/19-20/7949 05/08/2019 | Serial | 088 Last Visit: 16/08/2019 |
| Patient Name | Mrs. ANIMA SAMANTA | Contact No | 9143002427 |
| Address | CHTOBELUR CHECK POST | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||