Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02001 | Date 16/11/2018 |
| Token No | SM/18-19/3792 16/11/2018 | Serial | 025 Last Visit: 06/04/2020 |
| Patient Name | Mrs. ASHA BARIK | Contact No | 9330762231 |
| Address | CHATRA SHITLATALA KUMOR BAGAN , BAIDYABATI (M) | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||