Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00250 | Date 08/08/2018 |
| Token No | SM/20-21/30495 08/03/2021 | Serial | 020 Last Visit: 10/03/2021 |
| Patient Name | Mrs. PREMLATA HALDAR | Contact No | 9874205629 |
| Address | CHATRA BOU BAJAR | Age | 60 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||