Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03746 | Date 21/02/2019 |
| Token No | SM/18-19/9264 22/02/2019 | Serial | 041 Last Visit: 05/03/2019 |
| Patient Name | Mrs. SHARMILA PAL | Contact No | 9830460282 |
| Address | 57 CHATRA DHARMOTALA LANE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||