Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04296 | Date 19/03/2019 |
| Token No | SM/18-19/10838 19/03/2019 | Serial | 031 Last Visit: 19/03/2019 |
| Patient Name | Mrs. LAKHI DHARA | Contact No | |
| Address | CHATRA MANNA PARA | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/70 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||