Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06299 | Date 02/09/2019 |
| Token No | SM/19-20/10339 14/09/2019 | Serial | 018 Last Visit: 14/09/2019 |
| Patient Name | Miss SAJIYA SULTANA | Contact No | 9748706309 |
| Address | 34/3 GHANDHI SARAK ,RISHR (M) | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||