Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03639 | Date 18/02/2019 |
| Token No | SM/18-19/8874 18/02/2019 | Serial | 047 Last Visit: 18/02/2019 |
| Patient Name | Miss SUSHMITA RIK | Contact No | |
| Address | CHOTO BELUR | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||