Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09779 | Date 30/06/2021 |
| Token No | SM/21-22/2727 30/06/2021 | Serial | 033 Last Visit: 30/06/2021 |
| Patient Name | Mrs. DIPALI PARTRA | Contact No | |
| Address | CHATRA,TETULTALA,BAIDYABATI(M) | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||