Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00102 | Date 03/08/2018 |
| Token No | SM/18-19/104 03/08/2018 | Serial | 021 Last Visit: 21/08/2018 |
| Patient Name | Mrs. MAMTA SHAW | Contact No | 8013504463 |
| Address | SOUTH BHATCHARJEE PARA | Age | 27.0 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||