Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05239 | Date 27/05/2019 |
| Token No | SM/19-20/3465 27/05/2019 | Serial | 021 Last Visit: 09/01/2020 |
| Patient Name | Mrs. JHARNA DAS | Contact No | 8420785894 |
| Address | 89 CHATRA BARUI PARA | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||