Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01204 | Date 19/09/2018 |
| Token No | SM/18-19/1791 19/09/2018 | Serial | 003 Last Visit: 19/09/2018 |
| Patient Name | Mrs. RIYA DAS | Contact No | 9874011053 |
| Address | 65/14/2 PRABHAS NAGAR CHAKLA PARA | Age | 27 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||