Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02008 | Date 16/11/2018 |
| Token No | SM/18-19/3808 16/11/2018 | Serial | 041 Last Visit: 16/11/2018 |
| Patient Name | Mrs. MAHUYA DAS | Contact No | 6290266941 |
| Address | 32, CHATRA DHARMOTALA LANE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||