Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03307 | Date 02/02/2019 |
| Token No | SM/18-19/7822 02/02/2019 | Serial | 011 Last Visit: 02/02/2019 |
| Patient Name | Miss MOHAR BHADURI | Contact No | 9883334181 |
| Address | 19 LAHIRI PARA LANE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||