Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00490 | Date 16/08/2018 |
| Token No | SM/19-20/2180 04/05/2019 | Serial | 040 Last Visit: 04/05/2019 |
| Patient Name | Baby RITIKA GANGAPUTRA | Contact No | 8481841790 |
| Address | 85, A.P GHOSH ROAD | Age | 3 Y 5M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||