Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01319 | Date 25/09/2018 |
| Token No | SM/18-19/2033 25/09/2018 | Serial | 015 Last Visit: 25/09/2018 |
| Patient Name | Mrs. SWAPAN SOM | Contact No | 8478035276 |
| Address | 24/A CHATRA BARUI PARA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||