Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02579 | Date 18/12/2018 |
| Token No | SM/19-20/1982 30/04/2019 | Serial | 050 Last Visit: 30/04/2019 |
| Patient Name | Mrs. SILA PANDIT | Contact No | 9143825070 |
| Address | CHATRA LONKAR BAGAN | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||