Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02296 | Date 03/12/2018 |
| Token No | SM/18-19/4561 03/12/2018 | Serial | 027 Last Visit: 03/12/2018 |
| Patient Name | Mrs. LAKHIBALA PAL | Contact No | 9330829764 |
| Address | CHATRA TETUL TALA | Age | 95 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 170/70 mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||