Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02531 | Date 14/12/2018 |
| Token No | SM/18-19/5248 14/12/2018 | Serial | 037 Last Visit: 14/12/2018 |
| Patient Name | Miss PUNAM DAS | Contact No | |
| Address | CHATRA BARUI PARA LANE | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||