Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02751 | Date 31/12/2018 |
| Token No | SM/18-19/6014 31/12/2018 | Serial | 013 Last Visit: 31/12/2018 |
| Patient Name | Mrs. BHARATI SIGHA | Contact No | |
| Address | CHATRA CHOWDHURY PARA | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||