Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01215 | Date 19/09/2018 |
| Token No | SM/18-19/1811 19/09/2018 | Serial | 023 Last Visit: 19/09/2018 |
| Patient Name | Mrs. MANJU DAS | Contact No | 9143704331 |
| Address | CHATRA LANKAR BAGAN, BAIDYABATI (M) | Age | 60 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/90 mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||