Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03877 | Date 26/02/2019 |
| Token No | SM/18-19/10044 07/03/2019 | Serial | 047 Last Visit: 07/03/2019 |
| Patient Name | Mrs. SHIKA SARMA | Contact No | 9874591412 |
| Address | 67, CHATRA DHARMATALA LANE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||