Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03638 | Date 18/02/2019 |
| Token No | SM/19-20/1040 17/04/2019 | Serial | 047 Last Visit: 25/11/2019 |
| Patient Name | Miss PRIYANKA RIK | Contact No | 7044722926 |
| Address | CHOTO BELUR | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||