Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02089 | Date 22/11/2018 |
| Token No | SM/18-19/4043 22/11/2018 | Serial | 038 Last Visit: 01/12/2018 |
| Patient Name | Mrs. DEBASHRI SAHA | Contact No | 7044689260 |
| Address | CHATRA MUSALMAN PARA | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||