Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00096 | Date 03/08/2018 |
| Token No | SM/18-19/4338 28/11/2018 | Serial | 070 Last Visit: 01/02/2021 |
| Patient Name | Mrs. KALABATI RAJAK | Contact No | 9748750664 |
| Address | 12, CHATRA BAJAR ROAD | Age | 60.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||