Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03637 | Date 18/02/2019 |
| Token No | SM/19-20/3144 21/05/2019 | Serial | 092 Last Visit: 05/07/2019 |
| Patient Name | Mrs. JAGUMAYA MALLICK | Contact No | 8017641053 |
| Address | CHATRA MANNA PARA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||