Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07769 | Date 12/03/2020 |
| Token No | SM/21-22/1780 29/05/2021 | Serial | 019 Last Visit: 29/05/2021 |
| Patient Name | Miss LATIKA DAS | Contact No | 9073441255 |
| Address | CHAK BAIDYABATI GAILA PARA | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||