Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01598 | Date 10/10/2018 |
| Token No | SM/18-19/9776 02/03/2019 | Serial | 095 Last Visit: 02/03/2019 |
| Patient Name | Mrs. BANI DAS | Contact No | |
| Address | CHATRA DHARMA TALA LANE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||