Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00851 | Date 31/08/2018 |
| Token No | SM/18-19/1097 31/08/2018 | Serial | 011 Last Visit: 31/08/2018 |
| Patient Name | Mrs. MOLLIKA GUI | Contact No | 8100478783 |
| Address | CHATRA TETULTALA,MANIK GHOSH BAGAN | Age | 60.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 172/93 mmHg | Weight | 81 KG |
| Pulse Rate | 82 / min | Height | cm BMI: inf |
| Diagnosis | |||