Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08199 | Date 02/05/2020 |
| Token No | SM/19-20/21847 02/05/2020 | Serial | 029 Last Visit: 02/05/2020 |
| Patient Name | Mrs. MINOTI PAL | Contact No | |
| Address | 54/A CHATRA DUTTAPARA | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||