Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05641 | Date 02/07/2019 |
| Token No | SM/19-20/5755 02/07/2019 | Serial | 045 Last Visit: 02/07/2019 |
| Patient Name | Mrs. RADHIKA DEBI | Contact No | 8482080619 |
| Address | CHATRA CHOWDHURI PARA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||