Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02133 | Date 26/11/2018 |
| Token No | SM/18-19/7640 31/01/2019 | Serial | 014 Last Visit: 15/03/2019 |
| Patient Name | Mrs. PRATIMA GUIN | Contact No | |
| Address | CHATRA BARUI PARA | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||