Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 00635 | Date 23/08/2018 |
| Token No | SM/18-19/3184 30/10/2018 | Serial | 055 Last Visit: 30/08/2019 |
| Patient Name | Mrs. SIKHA RANI DAS | Contact No | 9874530525 |
| Address | 57/A PATUA PARA LANE | Age | 40.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 160/100 mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||