Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02490 | Date 12/12/2018 |
| Token No | SM/18-19/5137 12/12/2018 | Serial | 051 Last Visit: 12/12/2018 |
| Patient Name | Mrs. LAXMI MONDAL | Contact No | 9432592749 |
| Address | CHATRA SETALATALA | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||