Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00755 | Date 28/08/2018 |
| Token No | SM/18-19/935 28/08/2018 | Serial | 005 Last Visit: 19/08/2019 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 9164705513 |
| Address | 204/78G BAGER BAGAN CHATRA | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 185/117 mmHg | Weight | 64 KG |
| Pulse Rate | 79 / min | Height | cm BMI: inf |
| Diagnosis | |||