Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02312 | Date 03/12/2018 |
| Token No | SM/18-19/4605 03/12/2018 | Serial | 071 Last Visit: 03/12/2018 |
| Patient Name | Mrs. NIVHA DAS | Contact No | 8013074369 |
| Address | CHATRA BAGER BAGAN,BAIDYABATY(M) | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 160/100 mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||