Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02571 | Date 18/12/2018 |
| Token No | SM/22-23/19429 04/01/2023 | Serial | 010 Last Visit: 04/01/2023 |
| Patient Name | Miss PIYA DAS | Contact No | 9038485220 |
| Address | 65 CHATRA LANKAR BAGAN | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||