Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 01015 | Date 10/09/2018 |
| Token No | SM/18-19/1429 10/09/2018 | Serial | 017 Last Visit: 10/09/2018 |
| Patient Name | Mrs. REKHA KUNDU | Contact No | |
| Address | 15, RAJA K.L GOSWAMI STREET | Age | 80.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||