Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02502 | Date 13/12/2018 |
| Token No | SM/18-19/5174 13/12/2018 | Serial | 021 Last Visit: 13/12/2018 |
| Patient Name | Mrs. SABARI DUTTA | Contact No | 9831740025 |
| Address | CHATRA BHADURIPARA | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 98 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||