Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02006 | Date 16/11/2018 |
| Token No | SM/19-20/4759 18/06/2019 | Serial | 017 Last Visit: 12/09/2019 |
| Patient Name | Mrs. BANI DAS | Contact No | 7890413831 |
| Address | 37A CHATRA DHARMOTALA LANE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||