Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02971 | Date 11/01/2019 |
| Token No | SM/18-19/6705 11/01/2019 | Serial | 062 Last Visit: 06/10/2020 |
| Patient Name | Mrs. SIKHA MONDOL | Contact No | |
| Address | CHATRA DHARMATALA | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||