Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 01958 | Date 14/11/2018 |
| Token No | SM/18-19/3671 14/11/2018 | Serial | 060 Last Visit: 05/04/2019 |
| Patient Name | Mrs. KAKALI BERA | Contact No | 9748353681 |
| Address | CHATRA MANNA PARA | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||