Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02364 | Date 06/12/2018 |
| Token No | SM/18-19/4749 06/12/2018 | Serial | 004 Last Visit: 01/08/2019 |
| Patient Name | Mrs. TANIMA GOSWAMI | Contact No | 9748493109 |
| Address | 31, THAKUR DAS BABU LANE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||