Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01341 | Date 26/09/2018 |
| Token No | SM/18-19/2075 26/09/2018 | Serial | 004 Last Visit: 26/09/2018 |
| Patient Name | Mrs. LAKHI RANI RAY | Contact No | |
| Address | CHATRA BAGER BAGAN BAIDYABATI (M) | Age | 70 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 146/85 mmHg | Weight | 55 KG |
| Pulse Rate | 68 / min | Height | cm BMI: inf |
| Diagnosis | |||