Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02859 | Date 07/01/2019 |
| Token No | SM/18-19/6382 07/01/2019 | Serial | 036 Last Visit: 08/01/2019 |
| Patient Name | Mrs. TAPASHI SOM | Contact No | |
| Address | 121 CHATRA BARUI PARA | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||