Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01582 | Date 09/10/2018 |
| Token No | SM/18-19/2647 09/10/2018 | Serial | 036 Last Visit: 09/10/2018 |
| Patient Name | Mrs. KANCHAN MONDOL | Contact No | 9051611095 |
| Address | CHATRA BAGHERB BAGAN | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/60 mmHg | Weight | 73.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||