Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03130 | Date 22/01/2019 |
| Token No | SM/18-19/7247 22/01/2019 | Serial | 018 Last Visit: 22/01/2019 |
| Patient Name | Miss MOULINA KUNDU | Contact No | 9051496077 |
| Address | 14 BHADURI PARA | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||