Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 00947 | Date 06/09/2018 |
| Token No | SM/18-19/1291 06/09/2018 | Serial | 016 Last Visit: 06/09/2018 |
| Patient Name | Mrs. SUMAN SHAW | Contact No | 7059336784 |
| Address | 31, BAJAR BYE LINE (TINBAJAR) | Age | 9.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||