Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02164 | Date 27/11/2018 |
| Token No | SM/18-19/4261 27/11/2018 | Serial | 053 Last Visit: 27/09/2021 |
| Patient Name | Miss MUTUSHI PAL | Contact No | 9163027898 |
| Address | 14 CHATRA BARUI PARA | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||