Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01224 | Date 19/09/2018 |
| Token No | SM/18-19/1829 19/09/2018 | Serial | 041 Last Visit: 19/09/2018 |
| Patient Name | Mrs. CHHABI BHAKAT | Contact No | 9883736858 |
| Address | CHATRA TELI PARA , BAIDYABATI (M) | Age | 54 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||