Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06613 | Date 14/10/2019 |
| Token No | SM/19-20/11612 14/10/2019 | Serial | 006 Last Visit: 14/10/2019 |
| Patient Name | Mrs. FARIDA KHATOON | Contact No | 7439237995 |
| Address | 31/A GANDHI SARAK,RISHRA | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||