Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04160 | Date 11/03/2019 |
| Token No | SM/18-19/11239 26/03/2019 | Serial | 032 Last Visit: 27/09/2019 |
| Patient Name | Miss ISHIKA GHUGHU | Contact No | 8240289736 |
| Address | SEORAPHULI PIARAPUR PASCHIMPARA | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||