Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01480 | Date 03/10/2018 |
| Token No | SM/18-19/2387 03/10/2018 | Serial | 042 Last Visit: 03/10/2018 |
| Patient Name | Mrs. RAI SARDAR | Contact No | 7596897743 |
| Address | CHATRA LANKER BAGAN | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||