Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06308 | Date 02/09/2019 |
| Token No | SM/19-20/11957 17/10/2019 | Serial | 067 Last Visit: 17/04/2020 |
| Patient Name | Mrs. PADMAWATI DAS | Contact No | 9748995906 |
| Address | 8/3 HARIJAN ROAD CHATRA LANKAR BAGAN | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||