Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01246 | Date 20/09/2018 |
| Token No | SM/18-19/1873 20/09/2018 | Serial | 024 Last Visit: 20/09/2018 |
| Patient Name | Mrs. DISA DALAL | Contact No | 8420089950 |
| Address | 82 CHATRA BARUIPARA LANE | Age | 19 YER Female |
| Token For | Medicine, | Charge | Free |
| B.P | 114/88 mmHg | Weight | 45 KG |
| Pulse Rate | 132 / min | Height | cm BMI: inf |
| Diagnosis | |||