Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02781 | Date 02/01/2019 |
| Token No | SM/18-19/6121 02/01/2019 | Serial | 030 Last Visit: 11/06/2019 |
| Patient Name | Mrs. PRATIMA MOHANTI | Contact No | 9051580185 |
| Address | CHATRA KUMAR PARA SERAMPORE | Age | 32 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | 128/80 mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||