Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00484 | Date 16/08/2018 |
| Token No | SM/18-19/5014 10/12/2018 | Serial | 062 Last Visit: 04/04/2020 |
| Patient Name | Mrs. SEFALI BERA | Contact No | 9231350516 |
| Address | 14, CHATRA BAJAR ROAD | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||