Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08185 | Date 30/04/2020 |
| Token No | SM/20-21/27539 12/11/2020 | Serial | 045 Last Visit: 12/11/2020 |
| Patient Name | Other SUB CENTER VACCINATION CAMP | Contact No | |
| Address | UPHC-II, RAKHI BHOWMICK | Age | 1 Year Other |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||