Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01878 | Date 03/11/2018 |
| Token No | SM/18-19/9332 23/02/2019 | Serial | 018 Last Visit: 12/04/2019 |
| Patient Name | Mrs. BIJAYA DAS | Contact No | |
| Address | 23 ROY GHAT LANE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||