Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01873 | Date 03/11/2018 |
| Token No | SM/18-19/4832 07/12/2018 | Serial | 026 Last Visit: 07/12/2018 |
| Patient Name | Mrs. SABITA CHOWDHURY | Contact No | |
| Address | CHATRA TETULTALA | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||