Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 02194 | Date 29/11/2018 |
| Token No | SM/19-20/7493 29/07/2019 | Serial | 029 Last Visit: 07/08/2019 |
| Patient Name | Mrs. SUDMIYA DAS | Contact No | |
| Address | KM SAHA STREET | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||