Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01850 | Date 02/11/2018 |
| Token No | SM/18-19/3326 02/11/2018 | Serial | 010 Last Visit: 02/11/2018 |
| Patient Name | Mrs. SWARNALI SIL | Contact No | 8274968615 |
| Address | SHEWRAPHULI, BAIDYABATI (M) | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||