Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02805 | Date 03/01/2019 |
| Token No | SM/18-19/6199 03/01/2019 | Serial | 036 Last Visit: 19/01/2019 |
| Patient Name | Mrs. ASIMA MALLICK | Contact No | |
| Address | 20, BAHURE PARA , SHEWRAPHULI , BAIDYABATI(M) | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||