Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03560 | Date 13/02/2019 |
| Token No | SM/18-19/8613 13/02/2019 | Serial | 080 Last Visit: 13/02/2019 |
| Patient Name | Miss SOVA DAS | Contact No | 9038495178 |
| Address | SEORAPHULI,CHATU GANG | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||