Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00208 | Date 07/08/2018 |
| Token No | SM/18-19/7750 01/02/2019 | Serial | 026 Last Visit: 15/02/2020 |
| Patient Name | Mrs. RANITA HAZRA | Contact No | 8420915145 |
| Address | 3/A DUTTA PARA LANE, CHATRA | Age | 38YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||