Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01433 | Date 01/10/2018 |
| Token No | SM/19-20/10367 14/09/2019 | Serial | 046 Last Visit: 20/04/2020 |
| Patient Name | Mrs. SHANTI BARIK | Contact No | 7044629291 |
| Address | CHOTO BELU, MAHISYA PARA | Age | 74 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||