Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00768 | Date 28/08/2018 |
| Token No | SM/19-20/7198 24/07/2019 | Serial | 040 Last Visit: 24/07/2019 |
| Patient Name | Mrs. SWAPNA MONDAL | Contact No | 9051834575 |
| Address | 206A/D BAGER BAGAN CHATRA | Age | 38.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/60 mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||