Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03104 | Date 21/01/2019 |
| Token No | SM/18-19/7151 21/01/2019 | Serial | 019 Last Visit: 21/01/2019 |
| Patient Name | Mrs. CHANDANI KUNDU | Contact No | 9051496077 |
| Address | CHATRA BHADURI PARA | Age | 46 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||