Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06894 | Date 18/11/2019 |
| Token No | SM/19-20/13488 18/11/2019 | Serial | 063 Last Visit: 18/11/2019 |
| Patient Name | Miss FARAH KHATOON | Contact No | |
| Address | CHECK POST BARO BELUR MILKI BADAM TALA | Age | 5.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||