Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00780 | Date 28/08/2018 |
| Token No | SM/18-19/970 28/08/2018 | Serial | 040 Last Visit: 28/08/2018 |
| Patient Name | Mrs. LILIMA GHOSAL | Contact No | 9477969356 |
| Address | 14, PANCHANAN TALA | Age | 53.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 141/83 mmHg | Weight | 70 KG |
| Pulse Rate | 84 / min | Height | cm BMI: inf |
| Diagnosis | |||