Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01926 | Date 12/11/2018 |
| Token No | SM/18-19/5569 21/12/2018 | Serial | 019 Last Visit: 06/06/2020 |
| Patient Name | Mrs. SHIBANI LAHA | Contact No | 26524046 |
| Address | 34 CHATRA BARUI PARA LANE | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||