Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00023 | Date 01/08/2018 |
| Token No | SM/18-19/4596 03/12/2018 | Serial | 062 Last Visit: 31/12/2018 |
| Patient Name | Mrs. JAYA KARMAKAR | Contact No | 9674118254 |
| Address | 24 THAKURDAS BABU LANE | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||