Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03916 | Date 28/02/2019 |
| Token No | SM/18-19/10019 07/03/2019 | Serial | 022 Last Visit: 07/03/2019 |
| Patient Name | Mrs. TANUSHREE LAHA | Contact No | 7450061020 |
| Address | 101A BARUI PARA LANE CHATRA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||