Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00444 | Date 14/08/2018 |
| Token No | SM/18-19/495 14/08/2018 | Serial | 036 Last Visit: 05/09/2018 |
| Patient Name | Mrs. RUPOSONA BEGUM | Contact No | 9748396454 |
| Address | 9/E, MUSALMAN PARA BYE LANE, CHATRA SERAMPORE | Age | 35.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 115/75 mmHg | Weight | 66 KG |
| Pulse Rate | 81 / min | Height | cm BMI: inf |
| Diagnosis | |||