Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05202 | Date 22/05/2019 |
| Token No | SM/19-20/3240 22/05/2019 | Serial | 081 Last Visit: 22/03/2021 |
| Patient Name | Mrs. SABITRI PAKRE | Contact No | 9836512358 |
| Address | 77(96)/5 R K ROAD CHATRA MANNA PARA BAIDYABATI M | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||