Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04702 | Date 13/04/2019 |
| Token No | SM/19-20/878 13/04/2019 | Serial | 038 Last Visit: 13/04/2019 |
| Patient Name | Mrs. AISA BEGAM | Contact No | 6289003858 |
| Address | MAILA DUBU SHEWRAPHULI , BAIDYABATI(M) | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||