Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01812 | Date 01/11/2018 |
| Token No | SM/18-19/3255 01/11/2018 | Serial | 004 Last Visit: 16/07/2019 |
| Patient Name | Mrs. PUJA MALLICK | Contact No | 6290339198 |
| Address | CHATRA A P GHOSH ROAD | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||