Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01630 | Date 11/10/2018 |
| Token No | SM/18-19/6624 10/01/2019 | Serial | 051 Last Visit: 19/08/2021 |
| Patient Name | Mrs. LAKSHMI DUTTA | Contact No | |
| Address | 130 CHATRA BARUI PARA, | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||