Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01115 | Date 13/09/2018 |
| Token No | SM/18-19/1624 13/09/2018 | Serial | 047 Last Visit: 13/09/2018 |
| Patient Name | Mrs. JAYA MALICK | Contact No | 8017648277 |
| Address | 115/A RB SARANI | Age | 28.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 116/66 mmHg | Weight | 57 KG |
| Pulse Rate | 85 / min | Height | cm BMI: inf |
| Diagnosis | |||