Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00581 | Date 20/08/2018 |
| Token No | SM/19-20/11144 26/09/2019 | Serial | 028 Last Visit: 23/05/2020 |
| Patient Name | Mrs. CHHOBI SOM | Contact No | 9836354480 |
| Address | 124/C CHATRA BARUI PARA | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||