Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02511 | Date 13/12/2018 |
| Token No | SM/18-19/6607 10/01/2019 | Serial | 034 Last Visit: 12/03/2019 |
| Patient Name | Mrs. SHOVA MOHANTI | Contact No | 9830543460 |
| Address | 24 A CHATRA KUMORPARA | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||