Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03703 | Date 19/02/2019 |
| Token No | SM/18-19/9046 19/02/2019 | Serial | 076 Last Visit: 19/02/2019 |
| Patient Name | Mrs. DOLI PARUI | Contact No | 9874679664 |
| Address | CHATRA BAGHER BAGAN,BATI(M) | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||