Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00618 | Date 21/08/2018 |
| Token No | SM/18-19/2774 11/10/2018 | Serial | 037 Last Visit: 11/10/2018 |
| Patient Name | Mrs. ANGUL BALA SDHUKHAN | Contact No | 9681065397 |
| Address | 3, DHARMOTALA CHATRA | Age | 76.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||