Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00480 | Date 16/08/2018 |
| Token No | SM/19-20/4887 20/06/2019 | Serial | 027 Last Visit: 20/06/2019 |
| Patient Name | Mrs. KAKOKLI LAHA | Contact No | 9163685518 |
| Address | 81, SHITLATALA CHATRA | Age | 41.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||