Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00391 | Date 13/08/2018 |
| Token No | SM/18-19/430 13/08/2018 | Serial | 021 Last Visit: 13/08/2018 |
| Patient Name | Mrs. LINA PARUI | Contact No | 9038908858 |
| Address | 14B, DUTTA'S LANE | Age | 60.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||