Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01562 | Date 06/10/2018 |
| Token No | SM/18-19/2609 06/10/2018 | Serial | 069 Last Visit: 06/10/2018 |
| Patient Name | Mrs. RENESA KUNDU | Contact No | 9163088560 |
| Address | 5, CHATRA CHOWDHURY PARA/ LANE | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||