Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05345 | Date 06/06/2019 |
| Token No | SM/19-20/4075 06/06/2019 | Serial | 051 Last Visit: 06/06/2019 |
| Patient Name | Mrs. LAKHI DAS | Contact No | 8981868177 |
| Address | CHATRA DAS PARA , BAIDYABATI(M) | Age | 63 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||