Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02576 | Date 18/12/2018 |
| Token No | SM/18-19/5409 18/12/2018 | Serial | 018 Last Visit: 18/12/2018 |
| Patient Name | Mrs. SARBANTI PAL | Contact No | 8017561217 |
| Address | CHATRA TETUL TALA | Age | 31 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||