Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02634 | Date 21/12/2018 |
| Token No | SM/18-19/6871 16/01/2019 | Serial | 017 Last Visit: 18/02/2019 |
| Patient Name | Mrs. DURGA BALA DUTTA | Contact No | |
| Address | CHATRA BARUI PARA | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||