Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01370 | Date 27/09/2018 |
| Token No | SM/19-20/25467 04/09/2020 | Serial | 038 Last Visit: 12/03/2021 |
| Patient Name | Mrs. LAKHI DAS | Contact No | 7003480347 |
| Address | 113, CHATRA DAS PARA | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||