Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05489 | Date 20/06/2019 |
| Token No | SM/19-20/4902 20/06/2019 | Serial | 042 Last Visit: 20/06/2019 |
| Patient Name | Miss SANGITA PATOWARI | Contact No | 9748051097 |
| Address | 63 DHARMATALA LANE,CHATRA | Age | 7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||