Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02521 | Date 14/12/2018 |
| Token No | SM/19-20/5841 05/07/2019 | Serial | 004 Last Visit: 05/07/2019 |
| Patient Name | Miss DEBDUTI DAS | Contact No | 9674944363 |
| Address | 135 A P GHOSH ROAD | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||