Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00604 | Date 21/08/2018 |
| Token No | SM/18-19/720 21/08/2018 | Serial | 018 Last Visit: 21/08/2018 |
| Patient Name | Mrs. SIWLI DAS | Contact No | |
| Address | 301M BAGER BAGAN CHATRA | Age | 32.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/68 mmHg | Weight | 52 KG |
| Pulse Rate | 93 / min | Height | cm BMI: inf |
| Diagnosis | |||