Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 00546 | Date 18/08/2018 |
| Token No | SM/18-19/879 27/08/2018 | Serial | 012 Last Visit: 27/08/2018 |
| Patient Name | Mrs. SABITA ROY | Contact No | 8583925019 |
| Address | SHAN PUKUR DHAR, BAIDYABATI M | Age | 42.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||