Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01417 | Date 29/09/2018 |
| Token No | SM/18-19/2234 29/09/2018 | Serial | 022 Last Visit: 29/09/2018 |
| Patient Name | Miss PRIYANKI DAS | Contact No | 8017536270 |
| Address | 4/A CHATRA SIDDHESWARI LANE | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 90/60 mmHg | Weight | 44.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||