Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04048 | Date 06/03/2019 |
| Token No | SM/18-19/9993 06/03/2019 | Serial | 083 Last Visit: 06/03/2019 |
| Patient Name | Miss SOUMI BERA | Contact No | 9748353681 |
| Address | CHATRA MANNA PARA | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||