Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00440 | Date 14/08/2018 |
| Token No | SM/18-19/11278 26/03/2019 | Serial | 071 Last Visit: 05/04/2019 |
| Patient Name | Mrs. KAMALIKA PAL | Contact No | 8017542170 |
| Address | 84B, BARUIPARA LANE, CHATRA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||