Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04652 | Date 09/04/2019 |
| Token No | SM/19-20/10937 23/09/2019 | Serial | 064 Last Visit: 28/02/2022 |
| Patient Name | Mrs. CHANDRIMA DAS | Contact No | 9674256958 |
| Address | 26 CHATRA DHARMA TALA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||