Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01390 | Date 27/09/2018 |
| Token No | SM/18-19/2164 27/09/2018 | Serial | 045 Last Visit: 27/09/2018 |
| Patient Name | Mrs. GITA RAJBHAR | Contact No | 8820164044 |
| Address | 4/D BARO BAGAN LANE | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 117/77 mmHg | Weight | 60 KG |
| Pulse Rate | 84 / min | Height | cm BMI: inf |
| Diagnosis | |||