Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02428 | Date 10/12/2018 |
| Token No | SM/18-19/7815 02/02/2019 | Serial | 004 Last Visit: 13/07/2019 |
| Patient Name | Mrs. JITEN PANJA | Contact No | 9732323048 |
| Address | KAIKALA,MOHONBATI | Age | 74 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||