Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03017 | Date 15/01/2019 |
| Token No | SM/18-19/6851 15/01/2019 | Serial | 044 Last Visit: 15/01/2019 |
| Patient Name | Mrs. SUSMITA DAS | Contact No | 9748165568 |
| Address | RISHRA | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||