Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00446 | Date 14/08/2018 |
| Token No | SM/18-19/498 14/08/2018 | Serial | 039 Last Visit: 19/03/2020 |
| Patient Name | Miss RACHANA MAZUMDAR | Contact No | 9804546177 |
| Address | 55, DHARMATALA LANE, CHATRA | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||