Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04308 | Date 19/03/2019 |
| Token No | SM/18-19/10892 19/03/2019 | Serial | 085 Last Visit: 19/03/2019 |
| Patient Name | Mrs. MUNMUN PURKAIT | Contact No | 9874878726 |
| Address | 10/B CHATRA DUTTA PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||