Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06853 | Date 14/11/2019 |
| Token No | SM/19-20/13174 14/11/2019 | Serial | 001 Last Visit: 14/11/2019 |
| Patient Name | Miss REHANA KHATOON | Contact No | 8820244743 |
| Address | 32 GANDHI SARAK , RISHRA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 31 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||