Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01861 | Date 02/11/2018 |
| Token No | SM/18-19/5236 14/12/2018 | Serial | 025 Last Visit: 17/08/2021 |
| Patient Name | Mrs. SHIBANI DAS | Contact No | 9163729057 |
| Address | 43B CHATRA DUTTA PARA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||