Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01855 | Date 02/11/2018 |
| Token No | SM/18-19/3342 02/11/2018 | Serial | 026 Last Visit: 02/11/2018 |
| Patient Name | Mrs. LAKHI DAS | Contact No | 9038192618 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||