Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02673 | Date 24/12/2018 |
| Token No | SM/18-19/7914 04/02/2019 | Serial | 010 Last Visit: 27/02/2019 |
| Patient Name | Baby AYUSH MANDOL | Contact No | 7003120843 |
| Address | CHATRA LAHIRY PARA | Age | 1 Y 6 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||