Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05249 | Date 27/05/2019 |
| Token No | SM/19-20/16663 13/01/2020 | Serial | 065 Last Visit: 13/01/2020 |
| Patient Name | Miss KASMIRA KHATUN | Contact No | 9748706309 |
| Address | RAMCHANDRA PUR DIARA | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||