Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03773 | Date 21/02/2019 |
| Token No | SM/18-19/10790 18/03/2019 | Serial | 089 Last Visit: 18/03/2019 |
| Patient Name | Mrs. CHAPA DAS | Contact No | 9062335537 |
| Address | CHATRA LANKER BAGAN,BAIDYABATI(M) | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||