Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 11184 | Date 24/06/2022 |
| Token No | SM/22-23/16400 06/09/2022 | Serial | 014 Last Visit: 06/09/2022 |
| Patient Name | Mrs. RINKI DAS | Contact No | 7059586137 |
| Address | 47/31 CHATRA DAS PARA BAIDYABATI(M) | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||