Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06886 | Date 16/11/2019 |
| Token No | SM/19-20/13385 16/11/2019 | Serial | 045 Last Visit: 16/11/2019 |
| Patient Name | Miss SAMPA MONDAL | Contact No | 8910800697 |
| Address | 1 CHATRA BARUI PARA | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 27 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||