Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02723 | Date 28/12/2018 |
| Token No | SM/18-19/9985 06/03/2019 | Serial | 075 Last Visit: 06/03/2019 |
| Patient Name | Mrs. NAMITA ASH | Contact No | 8961146236 |
| Address | 29A CHATRA DUTTA PARA | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||