Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06066 | Date 06/08/2019 |
| Token No | SM/19-20/8177 08/08/2019 | Serial | 042 Last Visit: 08/08/2019 |
| Patient Name | Miss SOMASHREE GUIN | Contact No | 8697845780 |
| Address | 90/1 CHATRA BARUI PARA LANE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||