Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03347 | Date 04/02/2019 |
| Token No | SM/18-19/7943 04/02/2019 | Serial | 039 Last Visit: 18/02/2019 |
| Patient Name | Mrs. SUMANA ADHIKARY | Contact No | 7687013930 |
| Address | CHATRA CHOUDHURY PARA LANE | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||