Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03361 | Date 04/02/2019 |
| Token No | SM/18-19/7993 04/02/2019 | Serial | 089 Last Visit: 18/05/2020 |
| Patient Name | Mrs. SANDHA DAS | Contact No | |
| Address | JHAKARI, | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||