Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06116 | Date 16/08/2019 |
| Token No | SM/19-20/8423 16/08/2019 | Serial | 006 Last Visit: 16/08/2019 |
| Patient Name | Mrs. ASHIMA DAS | Contact No | 9874090338 |
| Address | , AATHA GIAYA , SIGUR | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||