Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01133 | Date 14/09/2018 |
| Token No | SM/18-19/1653 14/09/2018 | Serial | 019 Last Visit: 14/09/2018 |
| Patient Name | Mrs. SANGITA RAKHIT | Contact No | 9073063650 |
| Address | 65/23/C CHATRA DAS PARA | Age | 32.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||