Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06403 | Date 14/09/2019 |
| Token No | SM/19-20/12310 23/10/2019 | Serial | 048 Last Visit: 14/11/2019 |
| Patient Name | Miss NEHA KHATOON | Contact No | 8443087179 |
| Address | 32 GANDHI SARAK , RISHRA (M) | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||