Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00543 | Date 18/08/2018 |
| Token No | SM/19-20/2810 15/05/2019 | Serial | 050 Last Visit: 03/03/2021 |
| Patient Name | Mrs. PIYALI POREL | Contact No | 9874057826 |
| Address | 32, BHADURI PARA LANE | Age | 18.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||