Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01696 | Date 27/10/2018 |
| Token No | SM/18-19/4751 06/12/2018 | Serial | 006 Last Visit: 06/12/2018 |
| Patient Name | Mrs. KANAN DAS | Contact No | 8013648998 |
| Address | CHATRA HARIJON ROAD | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||