Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06593 | Date 01/10/2019 |
| Token No | SM/19-20/11483 01/10/2019 | Serial | 101 Last Visit: 01/10/2019 |
| Patient Name | Miss SUROPAMA DAS | Contact No | 9748995906 |
| Address | 8 HARIJAN ROAD , BAIDYYBATI | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||