Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02551 | Date 17/12/2018 |
| Token No | SM/18-19/5323 17/12/2018 | Serial | 004 Last Visit: 17/12/2018 |
| Patient Name | Mrs. LAKHI RANI ROY | Contact No | |
| Address | SEORAPHULY,CHARABAGAN | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||