Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01881 | Date 03/11/2018 |
| Token No | SM/18-19/3415 03/11/2018 | Serial | 028 Last Visit: 03/11/2018 |
| Patient Name | Miss SOUMILI DUTTA | Contact No | |
| Address | 55 CHATRA BARUI PARA | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||