Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02412 | Date 08/12/2018 |
| Token No | SM/18-19/4891 08/12/2018 | Serial | 018 Last Visit: 08/12/2018 |
| Patient Name | Mrs. PRIYANKA GHOSH | Contact No | 8910069982 |
| Address | 8 DHARMOTALA LANE CHATRA | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||