Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 01646 | Date 12/10/2018 |
| Token No | SM/18-19/6053 31/12/2018 | Serial | 052 Last Visit: 31/12/2018 |
| Patient Name | Mrs. MONIKA DAS | Contact No | |
| Address | 3/167 MAHESH COLLNEY | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||