Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04028 | Date 06/03/2019 |
| Token No | SM/18-19/9951 06/03/2019 | Serial | 041 Last Visit: 28/03/2019 |
| Patient Name | Mrs. PRIYA PARUI | Contact No | 9143168993 |
| Address | CHATRA LANKER BAGAN,BAIDYABATI(M) | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||