Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05720 | Date 10/07/2019 |
| Token No | SM/19-20/6212 10/07/2019 | Serial | 080 Last Visit: 22/11/2022 |
| Patient Name | Mrs. MOLINA ADAK | Contact No | |
| Address | CHATRA KUMAR BAGAN | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||