Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03770 | Date 21/02/2019 |
| Token No | SM/18-19/9200 21/02/2019 | Serial | 062 Last Visit: 31/03/2020 |
| Patient Name | Mrs. PURNIMA MAJHI | Contact No | 8981187836 |
| Address | CHATRA GODERBAGAN BYE LANE VOGNATH DHAR | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||