Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01750 | Date 29/10/2018 |
| Token No | SM/18-19/3094 29/10/2018 | Serial | 066 Last Visit: 29/10/2018 |
| Patient Name | Miss TANUSHREE LAHA | Contact No | 8420600334 |
| Address | 101A CHATRA BARUI PARA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||