Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00866 | Date 31/08/2018 |
| Token No | SM/18-19/6137 02/01/2019 | Serial | 046 Last Visit: 04/01/2019 |
| Patient Name | Mrs. KANON DAS | Contact No | 9836324527 |
| Address | 58 CHATRA DUTTA PARA LANE | Age | 50.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||