Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01529 | Date 05/10/2018 |
| Token No | SM/18-19/5588 21/12/2018 | Serial | 038 Last Visit: 09/11/2019 |
| Patient Name | Mrs. BASANTI DAS | Contact No | 9681864671 |
| Address | CHATRA DAS PARA | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||