Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00773 | Date 28/08/2018 |
| Token No | SM/19-20/17700 06/02/2020 | Serial | 024 Last Visit: 06/02/2020 |
| Patient Name | Mrs. PARBATI DEVI | Contact No | 9831310175 |
| Address | RAJA K.L GOSWAMI STREET | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||