Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04015 | Date 05/03/2019 |
| Token No | SM/19-20/12715 05/11/2019 | Serial | 089 Last Visit: 05/11/2019 |
| Patient Name | Mrs. PARBATI PAL | Contact No | 9231963301 |
| Address | 55A CHATRA DHARMOTALA | Age | 32 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||