Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02181 | Date 28/11/2018 |
| Token No | SM/18-19/11366 27/03/2019 | Serial | 070 Last Visit: 27/05/2019 |
| Patient Name | Baby ISHRA MAJHI | Contact No | 9674795390 |
| Address | 80, CHATRA BARUI PARA | Age | 2 Y 2 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||