Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 02319 | Date 04/12/2018 |
| Token No | SM/18-19/6293 05/01/2019 | Serial | 008 Last Visit: 25/03/2019 |
| Patient Name | Mrs. NILIMA PAL | Contact No | 8017627172 |
| Address | CHATRA TETUL TALA BAZAR | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||