Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03635 | Date 18/02/2019 |
| Token No | SM/18-19/9933 06/03/2019 | Serial | 023 Last Visit: 07/03/2019 |
| Patient Name | Mrs. LAKHI LAHA | Contact No | 907649534 |
| Address | 73 CHATRA BARUI PARA | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||