Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04164 | Date 11/03/2019 |
| Token No | SM/19-20/6351 13/07/2019 | Serial | 015 Last Visit: 13/07/2019 |
| Patient Name | Mrs. SIKHA LAHA | Contact No | 9330021570 |
| Address | 26A CHATRA BARUI PARA SERAMPORE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||