Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00995 | Date 08/09/2018 |
| Token No | SM/18-19/1385 08/09/2018 | Serial | 014 Last Visit: 08/09/2018 |
| Patient Name | Mrs. AINDRINA PRAMANIK | Contact No | 8481050516 |
| Address | PIYARA PAHLAM PUR | Age | 10.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||