Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01405 | Date 28/09/2018 |
| Token No | SM/18-19/2424 04/10/2018 | Serial | 022 Last Visit: 04/10/2018 |
| Patient Name | Mrs. LAKHI DAS | Contact No | 9433640374 |
| Address | 30/B CHATRA DHARMOTALA | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||