Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02978 | Date 14/01/2019 |
| Token No | SM/18-19/6723 14/01/2019 | Serial | 014 Last Visit: 25/03/2019 |
| Patient Name | Mrs. CHUMKI DAS | Contact No | 9830685318 |
| Address | 3/A CHATRA CHOEDHURY PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/90 mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||