Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01649 | Date 12/10/2018 |
| Token No | SM/18-19/2828 12/10/2018 | Serial | 035 Last Visit: 12/10/2018 |
| Patient Name | Mrs. SHARAMA DEBNATH | Contact No | 9051482206 |
| Address | 21/A CHATRA GODAR BAGAN/ LANE | Age | 48 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/60 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||