Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 03031 | Date 16/01/2019 |
| Token No | SM/18-19/6905 16/01/2019 | Serial | 051 Last Visit: 01/02/2019 |
| Patient Name | Mrs. SANDHYA DAS | Contact No | 9007927899 |
| Address | 15 N.N RAY STREET | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 170/90 mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||