Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05445 | Date 15/06/2019 |
| Token No | SM/19-20/4649 15/06/2019 | Serial | 032 Last Visit: 15/06/2019 |
| Patient Name | Mrs. CHAPALA BAG | Contact No | 9163957541 |
| Address | 16 CHTRA MUSLMAN PARA ROAD | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 156/80 mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||