Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01671 | Date 26/10/2018 |
| Token No | SM/18-19/2887 26/10/2018 | Serial | 001 Last Visit: 26/10/2018 |
| Patient Name | Mrs. BABLI DABI | Contact No | 9163706650 |
| Address | J M LEHIRI LANE | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||