Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 01647 | Date 12/10/2018 |
| Token No | SM/18-19/2822 12/10/2018 | Serial | 029 Last Visit: 12/10/2018 |
| Patient Name | Mrs. PRATIMA PAL | Contact No | |
| Address | 1 LAHA NAGAR KOLONI | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||