Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01332 | Date 25/09/2018 |
| Token No | SM/18-19/6499 08/01/2019 | Serial | 053 Last Visit: 06/04/2021 |
| Patient Name | Mrs. ILA DAS | Contact No | 8479936870 |
| Address | 30 B CHATRA DHARMATALA LANE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||