Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08833 | Date 08/10/2020 |
| Token No | SM/20-21/26462 08/10/2020 | Serial | 025 Last Visit: 08/10/2020 |
| Patient Name | Mrs. MADHUMITA DAS | Contact No | 6290643492 |
| Address | 10 ARABINDA SARANI,CHATRA | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||