Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03606 | Date 16/02/2019 |
| Token No | SM/18-19/8778 16/02/2019 | Serial | 002 Last Visit: 16/02/2019 |
| Patient Name | Mrs. POULOMI DAS | Contact No | 8910494021 |
| Address | 3/C GHOSH PARA 1 ST. LANE,CHATRA | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||