Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00126 | Date 04/08/2018 |
| Token No | SM/20-21/25716 15/09/2020 | Serial | 041 Last Visit: 15/09/2020 |
| Patient Name | Mrs. BHABANI DUTTA | Contact No | |
| Address | CHATRA DUTTA PARA | Age | 90 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||