Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02092 | Date 22/11/2018 |
| Token No | SM/18-19/4050 22/11/2018 | Serial | 045 Last Visit: 22/11/2018 |
| Patient Name | Mrs. BARSHA DUTTA | Contact No | 8582848756 |
| Address | 33/2 CHATRA DUTTA PARA | Age | 18 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||