Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04709 | Date 16/04/2019 |
| Token No | SM/19-20/942 16/04/2019 | Serial | 058 Last Visit: 16/04/2019 |
| Patient Name | Mrs. PUJA DEY | Contact No | 9674467878 |
| Address | RISHRA BAHUARI MANSHA TALA | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||