Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 05844 | Date 19/07/2019 |
| Token No | SM/19-20/8490 16/08/2019 | Serial | 073 Last Visit: 16/08/2019 |
| Patient Name | Mrs. BASANTI ROY | Contact No | 9836989019 |
| Address | 83 RAJYADHARPUR,MALLICKPARA | Age | 67 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||