Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05586 | Date 26/06/2019 |
| Token No | SM/19-20/9571 31/08/2019 | Serial | 052 Last Visit: 25/01/2020 |
| Patient Name | Mrs. SUMANA HALDER | Contact No | 9748659582 |
| Address | CHATRA BAGER BAGAN | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||