Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01794 | Date 31/10/2018 |
| Token No | SM/18-19/3207 31/10/2018 | Serial | 011 Last Visit: 31/10/2018 |
| Patient Name | Mrs. SUKUMAR DAS | Contact No | |
| Address | 21/ N N ROY STREET | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||