Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06154 | Date 19/08/2019 |
| Token No | SM/19-20/8700 19/08/2019 | Serial | 154 Last Visit: 19/08/2019 |
| Patient Name | Mrs. KAMLA PAL | Contact No | |
| Address | KATAPUL | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||