Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01245 | Date 20/09/2018 |
| Token No | SM/18-19/1871 20/09/2018 | Serial | 022 Last Visit: 20/09/2018 |
| Patient Name | Mrs. SUSMITA SARDAR | Contact No | |
| Address | CHATRA BAGHER BAGAN | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 115/72 mmHg | Weight | 55 KG |
| Pulse Rate | 110 / min | Height | cm BMI: inf |
| Diagnosis | |||