Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01752 | Date 29/10/2018 |
| Token No | SM/18-19/3104 29/10/2018 | Serial | 076 Last Visit: 29/10/2018 |
| Patient Name | Mrs. JHUMA GHORAI | Contact No | |
| Address | BAGER BAGAN CHATRA , BAIDYABATI (M) | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 115/77 mmHg | Weight | 52 KG |
| Pulse Rate | 78 / min | Height | cm BMI: inf |
| Diagnosis | |||