Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02411 | Date 08/12/2018 |
| Token No | SM/18-19/5298 15/12/2018 | Serial | 030 Last Visit: 15/12/2018 |
| Patient Name | Mrs. MINATI DAS | Contact No | 9748507392 |
| Address | CHATRA DHARMOTALA LANE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||