Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02950 | Date 10/01/2019 |
| Token No | SM/18-19/6630 10/01/2019 | Serial | 057 Last Visit: 10/01/2019 |
| Patient Name | Miss MISHTI SHAW | Contact No | 7980016787 |
| Address | RISHRA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||