Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00641 | Date 23/08/2018 |
| Token No | SM/18-19/1024 29/08/2018 | Serial | 030 Last Visit: 02/03/2021 |
| Patient Name | Mrs. NANDA PATRA | Contact No | 9331557379 |
| Address | 21, CHATRA BAJAR ROAD | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||