Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02298 | Date 03/12/2018 |
| Token No | SM/18-19/5402 18/12/2018 | Serial | 011 Last Visit: 15/03/2019 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 9830646351 |
| Address | A P GHOSH ROAD ,CHATRA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||