Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03735 | Date 20/02/2019 |
| Token No | SM/18-19/9125 20/02/2019 | Serial | 063 Last Visit: 20/02/2019 |
| Patient Name | Mrs. MANU DAS | Contact No | 6291471414 |
| Address | CHATRA LANKAR BAGAN BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||