Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04888 | Date 24/04/2019 |
| Token No | SM/19-20/1561 24/04/2019 | Serial | 031 Last Visit: 24/04/2019 |
| Patient Name | Mrs. TANIMA DAS | Contact No | 9163195880 |
| Address | 44 CHATRA DAS PARA , BAIDYABATI(M) | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||