Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03247 | Date 31/01/2019 |
| Token No | SM/18-19/7657 31/01/2019 | Serial | 031 Last Visit: 31/01/2019 |
| Patient Name | Mrs. BATASI LAHA | Contact No | 8100837765 |
| Address | 60 DUTTA PARA | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||