Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03413 | Date 06/02/2019 |
| Token No | SM/18-19/8155 06/02/2019 | Serial | 049 Last Visit: 27/02/2019 |
| Patient Name | Mrs. MOUSUMI SOM | Contact No | 9748879788 |
| Address | 10 CHATRA CHOWDHURY PARA | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||