Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01638 | Date 12/10/2018 |
| Token No | SM/18-19/2795 12/10/2018 | Serial | 002 Last Visit: 12/06/2020 |
| Patient Name | Mrs. MANU KOLEY | Contact No | |
| Address | 134/D BAGHER BAGAN,BAIDUYABAT9IM | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/90 mmHg | Weight | 68 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||