Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02740 | Date 29/12/2018 |
| Token No | SM/18-19/5989 29/12/2018 | Serial | 044 Last Visit: 29/12/2018 |
| Patient Name | Mrs. SONALI MONDAL | Contact No | 8981194322 |
| Address | CHATRA PATI PARA , BAIDYABATI (M) | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||