Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08245 | Date 11/05/2020 |
| Token No | SM/19-20/22108 11/05/2020 | Serial | 016 Last Visit: 11/05/2020 |
| Patient Name | Mrs. RANI DEBI MAHATO | Contact No | 8697927843 |
| Address | 14 JAGAMOHAN LAHIRI LANE | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||