Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04430 | Date 27/03/2019 |
| Token No | SM/18-19/11391 27/03/2019 | Serial | 095 Last Visit: 28/05/2019 |
| Patient Name | Mrs. MANA BHUIYA | Contact No | 9143614983 |
| Address | NABAGRAM NOGAMOR , BAIDYABATI(M) | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||