Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00278 | Date 09/08/2018 |
| Token No | SM/19-20/1381 22/04/2019 | Serial | 096 Last Visit: 22/04/2019 |
| Patient Name | Mrs. NEHA KHATOON | Contact No | 8444979212 |
| Address | 7, CHATRA ARBINDO SARANI | Age | 12.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||