Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01208 | Date 19/09/2018 |
| Token No | SM/18-19/1800 19/09/2018 | Serial | 012 Last Visit: 19/09/2018 |
| Patient Name | Mrs. RITA DAS | Contact No | 8820333205 |
| Address | 6, P.N MUKHERJEE STREET | Age | 53 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||