Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 00526 | Date 17/08/2018 |
| Token No | SM/18-19/602 17/08/2018 | Serial | 040 Last Visit: 17/08/2018 |
| Patient Name | Mrs. PUSPA ROY | Contact No | 9674576689 |
| Address | 16, RAJA K.L. GOSWAMI STREET | Age | 45.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 154/94 mmHg | Weight | 60 KG |
| Pulse Rate | 120 / min | Height | cm BMI: inf |
| Diagnosis | |||