Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01010 | Date 10/09/2018 |
| Token No | SM/19-20/21800 01/05/2020 | Serial | 006 Last Visit: 01/05/2020 |
| Patient Name | Mrs. ADITI NAG | Contact No | 7890740434 |
| Address | 29/B CHATRA BAZAR ROAD | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||