Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01852 | Date 02/11/2018 |
| Token No | SM/18-19/3329 02/11/2018 | Serial | 013 Last Visit: 02/11/2018 |
| Patient Name | Mrs. RUPA MALICK | Contact No | |
| Address | A. P GHOSH ROAD | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||