Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01536 | Date 05/10/2018 |
| Token No | SM/18-19/8759 15/02/2019 | Serial | 047 Last Visit: 15/02/2019 |
| Patient Name | Mrs. DIPALI MONDAL | Contact No | |
| Address | CHATRA BAGHER BAGAN | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||