Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00597 | Date 21/08/2018 |
| Token No | SM/19-20/6503 15/07/2019 | Serial | 046 Last Visit: 27/11/2019 |
| Patient Name | Mrs. DOLLY PANDIT | Contact No | 9836038798 |
| Address | 13, CHTARA LAHIRI STREET | Age | 38.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||