Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05804 | Date 17/07/2019 |
| Token No | SM/19-20/7013 22/07/2019 | Serial | 031 Last Visit: 30/11/2019 |
| Patient Name | Mrs. NANDA DAS | Contact No | 7059872460 |
| Address | 3 SIDDHESWARI LANE,CHATRA | Age | 57 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||