Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02348 | Date 05/12/2018 |
| Token No | SM/18-19/4708 05/12/2018 | Serial | 032 Last Visit: 05/12/2018 |
| Patient Name | Mrs. NISA BHATTCHARJEE | Contact No | 8479985279 |
| Address | CHATRA MUSALMAN PARA | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||