Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06994 | Date 27/11/2019 |
| Token No | SM/19-20/14097 27/11/2019 | Serial | 006 Last Visit: 27/11/2019 |
| Patient Name | Miss SUHINA DAS | Contact No | 8820342310 |
| Address | 6 DR. P. N. MUKHERJEE STREET | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||