Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03146 | Date 22/01/2019 |
| Token No | SM/18-19/7298 22/01/2019 | Serial | 069 Last Visit: 22/01/2019 |
| Patient Name | Mrs. PRATIMA GARAI | Contact No | 9830392018 |
| Address | CHATRA DHARMATALA LANE | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||