Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00762 | Date 28/08/2018 |
| Token No | SM/19-20/1965 30/04/2019 | Serial | 033 Last Visit: 12/05/2020 |
| Patient Name | Mrs. LIPA DEY | Contact No | 9339596943 |
| Address | 30/I/B CHATRA CHOWDHURY PARA | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||