Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02002 | Date 16/11/2018 |
| Token No | SM/18-19/6864 16/01/2019 | Serial | 010 Last Visit: 16/01/2019 |
| Patient Name | Mrs. PUSPA DAS | Contact No | |
| Address | CHAPA TALA LANE , CHATRA | Age | 85 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 160/80 mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||