Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03139 | Date 22/01/2019 |
| Token No | SM/18-19/7281 22/01/2019 | Serial | 052 Last Visit: 24/06/2024 |
| Patient Name | Mrs. GAYA DOLUI | Contact No | 9874864241 |
| Address | 14 CHATRA MUSALMAN PARA | Age | 65 Years,4 Months,22 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||