Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06354 | Date 07/09/2019 |
| Token No | SM/19-20/9973 07/09/2019 | Serial | 042 Last Visit: 07/09/2019 |
| Patient Name | Mrs. MUNMUN ROY | Contact No | 8910509960 |
| Address | CHOTO BELU BELUMILKI | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||