Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 03185 | Date 25/01/2019 |
| Token No | SM/21-22/4336 24/08/2021 | Serial | 025 Last Visit: 24/08/2021 |
| Patient Name | Miss KRITIKA DAS | Contact No | |
| Address | CHATRA LANKER BAGAN | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||