Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05809 | Date 17/07/2019 |
| Token No | SM/19-20/6668 17/07/2019 | Serial | 040 Last Visit: 24/07/2019 |
| Patient Name | Mrs. SHILA PAL | Contact No | 9051612059 |
| Address | 36 KUMOR PARA LANE,CHATRA | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 52.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||