Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03419 | Date 06/02/2019 |
| Token No | SM/18-19/10914 20/03/2019 | Serial | 019 Last Visit: 20/03/2019 |
| Patient Name | Mrs. TAPSHI LAHA | Contact No | 9830084495 |
| Address | 63B CHATRA BARUI PARA LANE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||