Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02053 | Date 20/11/2018 |
| Token No | SM/18-19/3946 20/11/2018 | Serial | 024 Last Visit: 20/11/2018 |
| Patient Name | Mrs. UMA POLLEY | Contact No | |
| Address | 17, CHAKRABORTY PARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 160/90 mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||