Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02519 | Date 14/12/2018 |
| Token No | SM/18-19/6946 17/01/2019 | Serial | 026 Last Visit: 02/04/2019 |
| Patient Name | Mrs. CHANDRA PAL | Contact No | 8017544154 |
| Address | 84 A POTUA PARA LANE | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||