Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04559 | Date 04/04/2019 |
| Token No | SM/19-20/1062 17/04/2019 | Serial | 069 Last Visit: 17/04/2019 |
| Patient Name | Mrs. CHHOBI PATI | Contact No | |
| Address | CHATRA HARISEBA MUKHERJEE PARA | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||