Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00970 | Date 07/09/2018 |
| Token No | SM/18-19/1336 07/09/2018 | Serial | 008 Last Visit: 07/09/2018 |
| Patient Name | Mrs. PUJA PAL | Contact No | 9330005925 |
| Address | 14 CHATRA BARUI PARA | Age | 14.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||