Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02224 | Date 29/11/2018 |
| Token No | SM/18-19/4408 29/11/2018 | Serial | 069 Last Visit: 29/11/2018 |
| Patient Name | Miss RUPSA PAL | Contact No | 8017058019 |
| Address | BARUI PARA LANE CHATRA | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||