Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01207 | Date 19/09/2018 |
| Token No | SM/18-19/1797 19/09/2018 | Serial | 009 Last Visit: 19/09/2018 |
| Patient Name | Mrs. RINKU MAHATA | Contact No | |
| Address | CHOTO BELUR ARBINDA CHECK POST | Age | 30 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||