Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00152 | Date 06/08/2018 |
| Token No | SM/18-19/7407 24/01/2019 | Serial | 094 Last Visit: 24/01/2019 |
| Patient Name | Mrs. MITHU PAL | Contact No | 9830014671 |
| Address | 5, CHATRA BARUI PARA LANE | Age | 32 yrs Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||