Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02748 | Date 31/12/2018 |
| Token No | SM/18-19/6009 31/12/2018 | Serial | 008 Last Visit: 31/12/2018 |
| Patient Name | Mrs. JAYANTI DAS | Contact No | |
| Address | 41 CHAKRABORTY LANE | Age | 63 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||