Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01665 | Date 13/10/2018 |
| Token No | SM/18-19/2873 13/10/2018 | Serial | 027 Last Visit: 13/10/2018 |
| Patient Name | Mrs. NILIMA CHOWROSIA | Contact No | |
| Address | RISHRA ,GRAMPANCHYAT | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||