Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01655 | Date 12/10/2018 |
| Token No | SM/18-19/2841 12/10/2018 | Serial | 048 Last Visit: 12/10/2018 |
| Patient Name | Mrs. SANTANA KARAK | Contact No | 8481870261 |
| Address | CHATRA G T ROAD JAL TANK | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||