Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01116 | Date 13/09/2018 |
| Token No | SM/18-19/1626 13/09/2018 | Serial | 049 Last Visit: 13/09/2018 |
| Patient Name | Mrs. RUMPA PAL | Contact No | 9330005925 |
| Address | 14, CHATRA BARUI PARA LANE | Age | 35.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 99/64 mmHg | Weight | 49 KG |
| Pulse Rate | 94 / min | Height | cm BMI: inf |
| Diagnosis | |||