Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02969 | Date 11/01/2019 |
| Token No | SM/18-19/6691 11/01/2019 | Serial | 048 Last Visit: 11/01/2019 |
| Patient Name | Miss RIYA CHAKRABORTY | Contact No | 9874939202 |
| Address | 14/A LAHIRY PARA | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||