Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03780 | Date 22/02/2019 |
| Token No | SM/18-19/10451 12/03/2019 | Serial | 042 Last Visit: 12/03/2019 |
| Patient Name | Mrs. ITU ADHIKARI | Contact No | 9051717904 |
| Address | 14 CHATRA CHOWDHURI PARA LANE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||