Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01925 | Date 12/11/2018 |
| Token No | SM/18-19/10923 20/03/2019 | Serial | 028 Last Visit: 16/10/2019 |
| Patient Name | Mrs. ABHA DAS | Contact No | 9903567775 |
| Address | CHATRA LANKER BAGAN | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||