Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03069 | Date 18/01/2019 |
| Token No | SM/18-19/8346 08/02/2019 | Serial | 072 Last Visit: 08/02/2019 |
| Patient Name | Mrs. ARCHANA DAS | Contact No | 9874714182 |
| Address | 44 CHATRA DUTTA PARA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||