Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01421 | Date 29/09/2018 |
| Token No | SM/18-19/2247 29/09/2018 | Serial | 035 Last Visit: 29/09/2018 |
| Patient Name | Miss SIMRAN SHAW | Contact No | |
| Address | 136, KATAPUL NEW MAHESH | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||