Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03561 | Date 13/02/2019 |
| Token No | SM/18-19/8614 13/02/2019 | Serial | 081 Last Visit: 19/02/2020 |
| Patient Name | Mrs. KUMANTI DAS | Contact No | 9038495178 |
| Address | SEORAPHULI,CHATU GANG | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||