Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02185 | Date 28/11/2018 |
| Token No | SM/18-19/6823 15/01/2019 | Serial | 016 Last Visit: 15/01/2019 |
| Patient Name | Mrs. MITHU DAS | Contact No | 9674856143 |
| Address | 12/8 CHATRA DAS PARA , BAIDYABATI (M) | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||