Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 03058 | Date 18/01/2019 |
| Token No | SM/18-19/7004 18/01/2019 | Serial | 008 Last Visit: 18/01/2019 |
| Patient Name | Miss RIYA BHANDARI | Contact No | 9051624909 |
| Address | SHEWRAPHULI CHARA BAGAN, BAIDYABATI(M) | Age | 19 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||