Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01513 | Date 04/10/2018 |
| Token No | SM/18-19/8241 07/02/2019 | Serial | 068 Last Visit: 07/02/2019 |
| Patient Name | Mrs. SANDHYA MANA | Contact No | |
| Address | CHATRA SHTLATALA BAGER BAGAN | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||