Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08142 | Date 24/04/2020 |
| Token No | SM/19-20/21755 30/04/2020 | Serial | 039 Last Visit: 01/12/2020 |
| Patient Name | Mrs. KAMOLA DAS | Contact No | 8420281957 |
| Address | 135/A A.P. GHOSH ROAD CHATRA | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||