Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01231 | Date 19/09/2018 |
| Token No | SM/18-19/4864 07/12/2018 | Serial | 058 Last Visit: 07/12/2018 |
| Patient Name | Mrs. KABITA SOM | Contact No | 8981587054 |
| Address | 19, CHATRA BARUI PARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||