Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02257 | Date 01/12/2018 |
| Token No | SM/18-19/4481 01/12/2018 | Serial | 008 Last Visit: 20/03/2019 |
| Patient Name | Miss PURBASHA NATH | Contact No | 9804765711 |
| Address | 10/B CHATRA KUMAR PARA | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||