Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01412 | Date 29/09/2018 |
| Token No | SM/18-19/6896 16/01/2019 | Serial | 042 Last Visit: 08/05/2019 |
| Patient Name | Mrs. GITA RANI CHOWDHURI | Contact No | 8420919579 |
| Address | 10 CHATRA CHOWDHURI PARA BY LANE | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||