Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02690 | Date 27/12/2018 |
| Token No | SM/19-20/1357 22/04/2019 | Serial | 072 Last Visit: 25/08/2022 |
| Patient Name | Miss RESHMI MONDAL | Contact No | 9804344839 |
| Address | RAMKRISHNA BY LANE CHATRA | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||