Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02370 | Date 06/12/2018 |
| Token No | SM/18-19/4758 06/12/2018 | Serial | 013 Last Visit: 06/12/2018 |
| Patient Name | Mrs. RINA KAR | Contact No | 9051169588 |
| Address | 23A THAKUR DAS BABU LANE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||