Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00174 | Date 06/08/2018 |
| Token No | SM/19-20/16872 18/01/2020 | Serial | 040 Last Visit: 18/01/2020 |
| Patient Name | Miss RAYANA ANJU | Contact No | 9007517192 |
| Address | CHATRA BHADURI PARA | Age | 6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||