Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04292 | Date 19/03/2019 |
| Token No | SM/18-19/10823 19/03/2019 | Serial | 016 Last Visit: 19/03/2019 |
| Patient Name | Mrs. SIKHA DAS | Contact No | 983611482 |
| Address | SHORAPHULY,RAMKRISHNA NAGER, | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||