Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03512 | Date 12/02/2019 |
| Token No | SM/18-19/8987 19/02/2019 | Serial | 017 Last Visit: 19/08/2019 |
| Patient Name | Mrs. BASANTI PARUI | Contact No | |
| Address | 4 P.N MUKHERJEE STREET | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||