Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01954 | Date 14/11/2018 |
| Token No | SM/18-19/3656 14/11/2018 | Serial | 045 Last Visit: 14/11/2018 |
| Patient Name | Mrs. GANGA DAS | Contact No | 8420987631 |
| Address | VELLAGE PATUL | Age | 52 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||