Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02290 | Date 03/12/2018 |
| Token No | SM/18-19/6351 07/01/2019 | Serial | 005 Last Visit: 01/02/2019 |
| Patient Name | Mrs. UJJALA DAS | Contact No | 9143695656 |
| Address | 63 AP GHOSH ROAD,CHATRA | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||