Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00282 | Date 09/08/2018 |
| Token No | SM/18-19/2731 10/10/2018 | Serial | 056 Last Visit: 08/08/2019 |
| Patient Name | Mrs. SANDHYA KUNDU | Contact No | |
| Address | 3/A CHATRA DUTTA PARA | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||