Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05353 | Date 07/06/2019 |
| Token No | SM/19-20/4189 08/06/2019 | Serial | 037 Last Visit: 08/06/2019 |
| Patient Name | Mrs. SANDHA MARIK | Contact No | |
| Address | CHATRA BRABHATALA, | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||