Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02479 | Date 12/12/2018 |
| Token No | SM/18-19/5119 12/12/2018 | Serial | 033 Last Visit: 13/12/2018 |
| Patient Name | Mrs. DIPA DEY | Contact No | 9830171243 |
| Address | 58 PANCHANAN TALA | Age | 49YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||