Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06267 | Date 29/08/2019 |
| Token No | SM/19-20/9415 29/08/2019 | Serial | 056 Last Visit: 29/08/2019 |
| Patient Name | Mrs. BULA MARIK | Contact No | 8017213440 |
| Address | 46 DUTTA PARA LANE | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||