Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01944 | Date 14/11/2018 |
| Token No | SM/18-19/3615 14/11/2018 | Serial | 004 Last Visit: 14/11/2018 |
| Patient Name | Mrs. ANKUSH GUIN | Contact No | 8013355712 |
| Address | 90/A/2CHATRA BARUI PARA | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||