Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00781 | Date 28/08/2018 |
| Token No | SM/18-19/971 28/08/2018 | Serial | 041 Last Visit: 14/12/2018 |
| Patient Name | Mrs. MITHU SARDAR | Contact No | |
| Address | BAGER BAGAN TELI PARA | Age | 40.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 94/75 mmHg | Weight | 60 KG |
| Pulse Rate | 81 / min | Height | cm BMI: inf |
| Diagnosis | |||