Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01729 | Date 29/10/2018 |
| Token No | SM/18-19/3029 29/10/2018 | Serial | 001 Last Visit: 31/10/2018 |
| Patient Name | Mrs. PRABHA SEN | Contact No | |
| Address | 85, A.P GHOSH ROAD CHATRA | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 129/56 mmHg | Weight | 40 KG |
| Pulse Rate | 80 / min | Height | cm BMI: inf |
| Diagnosis | |||