Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02190 | Date 28/11/2018 |
| Token No | SM/18-19/4332 28/11/2018 | Serial | 064 Last Visit: 28/11/2018 |
| Patient Name | Mrs. MAMTA MALLICK | Contact No | 8481841790 |
| Address | 41, A.P GHOSH ROAD | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||