Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00430 | Date 14/08/2018 |
| Token No | SM/19-20/6607 16/07/2019 | Serial | 055 Last Visit: 14/12/2019 |
| Patient Name | Mrs. SWAPNA LAHA | Contact No | 7439187122 |
| Address | 13A, DUTTAPARA, CHATRA | Age | 30.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||