Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06123 | Date 16/08/2019 |
| Token No | SM/19-20/8466 16/08/2019 | Serial | 049 Last Visit: 16/08/2019 |
| Patient Name | Mrs. ANIMA RAY | Contact No | 8910341704 |
| Address | BAIDAPARA , BAIDYBATI (M) | Age | 56 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||