Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09117 | Date 31/12/2020 |
| Token No | SM/21-22/575 19/04/2021 | Serial | 042 Last Visit: 19/04/2021 |
| Patient Name | Miss ISHA DOM | Contact No | 9674154955 |
| Address | CHATRA KALI BABUR GHAT, | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||