Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00383 | Date 13/08/2018 |
| Token No | SM/20-21/26397 06/10/2020 | Serial | 052 Last Visit: 16/02/2022 |
| Patient Name | Miss MOUPARNA PAL | Contact No | 9007666856 |
| Address | 14, BARUIPARA LANE | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||