Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03851 | Date 25/02/2019 |
| Token No | SM/18-19/9413 25/02/2019 | Serial | 020 Last Visit: 25/02/2019 |
| Patient Name | Miss ISHA MALIK | Contact No | |
| Address | CHATRA KALIBABU GHAT | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||