Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09210 | Date 25/01/2021 |
| Token No | SM/20-21/29736 25/01/2021 | Serial | 020 Last Visit: 05/04/2021 |
| Patient Name | Mrs. PUSHPA DAS SANTRA | Contact No | 9874579157 |
| Address | GANGGA DHAR PURE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||