Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00542 | Date 18/08/2018 |
| Token No | SM/19-20/6188 10/07/2019 | Serial | 056 Last Visit: 03/02/2020 |
| Patient Name | Mrs. SHIBANI DAS | Contact No | 9836541892 |
| Address | DHARMOTALA LANE , CHATRA | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||