Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02013 | Date 16/11/2018 |
| Token No | SM/19-20/2021 30/04/2019 | Serial | 089 Last Visit: 30/04/2019 |
| Patient Name | Mrs. DEVI PAL | Contact No | 8335940344 |
| Address | 23A CHATRA KUMAR PARA | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||