Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00760 | Date 28/08/2018 |
| Token No | SM/19-20/5317 25/06/2019 | Serial | 073 Last Visit: 26/06/2019 |
| Patient Name | Mrs. KABITA SOM | Contact No | 8981587052 |
| Address | 19, BARUI PARA CHATRA | Age | 35.0 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||