Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01398 | Date 28/09/2018 |
| Token No | SM/18-19/2186 28/09/2018 | Serial | 015 Last Visit: 28/09/2018 |
| Patient Name | Mrs. MONI LAHA | Contact No | |
| Address | 130/E CHATRA BARUI PARA | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||