Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02286 | Date 03/12/2018 |
| Token No | SM/18-19/7909 04/02/2019 | Serial | 005 Last Visit: 04/02/2019 |
| Patient Name | Mrs. RINA MALLICK | Contact No | 9051998385 |
| Address | CHANDANGER | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||