Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10480 | Date 31/12/2021 |
| Token No | SM/21-22/8329 31/12/2021 | Serial | 016 Last Visit: 31/12/2021 |
| Patient Name | Miss SUSMITA BAURI | Contact No | 7407701549 |
| Address | GRODOYARA,BAKURA | Age | 7.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||