Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06297 | Date 31/08/2019 |
| Token No | SM/19-20/9603 31/08/2019 | Serial | 084 Last Visit: 31/08/2019 |
| Patient Name | Mrs. RINA DAS | Contact No | 7044627870 |
| Address | BEGAMPUR KHARASARAI | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||