Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03667 | Date 18/02/2019 |
| Token No | SM/18-19/8931 18/02/2019 | Serial | 104 Last Visit: 05/03/2019 |
| Patient Name | Mrs. KALPANA DAS | Contact No | 9831956800 |
| Address | 44 CHATRA DUTTA PARA | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||