Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00262 | Date 09/08/2018 |
| Token No | SM/18-19/7923 04/02/2019 | Serial | 019 Last Visit: 08/04/2021 |
| Patient Name | Mrs. ASHIMA SOM | Contact No | 9831510627 |
| Address | 124/C BARUI PARA SHIBTALA , CHATRA | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||