Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04333 | Date 20/03/2019 |
| Token No | SM/18-19/10991 20/03/2019 | Serial | 096 Last Visit: 20/03/2019 |
| Patient Name | Mrs. SAMPA SADHUKHA | Contact No | 9836534839 |
| Address | 3 CHATRA DHARMOTALA LANE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||