Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00786 | Date 28/08/2018 |
| Token No | SM/18-19/982 28/08/2018 | Serial | 052 Last Visit: 28/08/2018 |
| Patient Name | Mrs. PURKAIT MUNMUN | Contact No | 9874878726 |
| Address | 10/B DUTTA PARA CHATRA | Age | 33.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/72 mmHg | Weight | 55 KG |
| Pulse Rate | 97 / min | Height | cm BMI: inf |
| Diagnosis | |||