Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00648 | Date 23/08/2018 |
| Token No | SM/19-20/5035 21/06/2019 | Serial | 061 Last Visit: 22/05/2025 |
| Patient Name | Miss SOUMI POREL | Contact No | 9883262015 |
| Address | 17, CHAPA TALA LANE CHATRA | Age | 9 Years,4 Months,20 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||