Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03752 | Date 21/02/2019 |
| Token No | SM/18-19/9162 21/02/2019 | Serial | 024 Last Visit: 09/12/2019 |
| Patient Name | Mrs. RAJ SEKHAR DAS | Contact No | 9331706955 |
| Address | 3M CHATRA DUTTA PARA | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||