Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00806 | Date 29/08/2018 |
| Token No | SM/18-19/1087 31/08/2018 | Serial | 001 Last Visit: 01/11/2018 |
| Patient Name | Mrs. REBOTI DUTTA | Contact No | 9681676994 |
| Address | 52A CHATRA BARUIPARA LANE | Age | 74.0 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||