Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 00501 | Date 17/08/2018 |
| Token No | SM/18-19/10631 16/03/2019 | Serial | 013 Last Visit: 27/02/2020 |
| Patient Name | Mrs. PUSPA ROY | Contact No | 9007860479 |
| Address | MANA PARA MARADAN | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||