Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06505 | Date 23/09/2019 |
| Token No | SM/19-20/10923 23/09/2019 | Serial | 050 Last Visit: 01/10/2019 |
| Patient Name | Mrs. BITHIKA SOM | Contact No | 9831084038 |
| Address | 124/C BARUI PARA,SIB TALA, | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||