Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05299 | Date 30/05/2019 |
| Token No | SM/19-20/3737 30/05/2019 | Serial | 030 Last Visit: 30/05/2019 |
| Patient Name | Mrs. LAKASHMI SADHUKHAN | Contact No | 9836425005 |
| Address | 32 SHEWRAPHULI CHATUGANG UPENDRA NANDI ROAD | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||