Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02786 | Date 02/01/2019 |
| Token No | SM/18-19/6139 02/01/2019 | Serial | 048 Last Visit: 02/01/2019 |
| Patient Name | Mrs. ANJANA DAS | Contact No | |
| Address | 10 C CHATRA DUTTA PARA | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||