Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02855 | Date 07/01/2019 |
| Token No | SM/18-19/6375 07/01/2019 | Serial | 029 Last Visit: 25/02/2019 |
| Patient Name | Mrs. MALINA ADHIKARY | Contact No | |
| Address | 13/2 CHATRA CHOWDHURY PARA | Age | 67 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||