Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00959 | Date 06/09/2018 |
| Token No | SM/18-19/1315 06/09/2018 | Serial | 040 Last Visit: 06/09/2018 |
| Patient Name | Mrs. BANITA SHAW | Contact No | 8013504463 |
| Address | SOUTH BHATCHARJEE PARA | Age | 7.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||