Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06786 | Date 05/11/2019 |
| Token No | SM/19-20/12632 05/11/2019 | Serial | 006 Last Visit: 05/11/2019 |
| Patient Name | Mrs. FARIDA KHATOON | Contact No | 7044759881 |
| Address | 5/10 A.B ROAD , RISHRA | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||