Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02153 | Date 27/11/2018 |
| Token No | SM/19-20/9705 03/09/2019 | Serial | 016 Last Visit: 03/09/2019 |
| Patient Name | Miss REKHA DEY | Contact No | |
| Address | CHATRA DOL TALA | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||