Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01925 | Date 12/11/2018 |
| Token No | SM/19-20/6933 20/07/2019 | Serial | 036 Last Visit: 16/10/2019 |
| Patient Name | Mrs. ABHA DAS | Contact No | 9903567775 |
| Address | CHATRA LANKER BAGAN | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||