Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07339 | Date 14/01/2020 |
| Token No | SM/19-20/16690 14/01/2020 | Serial | 019 Last Visit: 14/01/2020 |
| Patient Name | Miss SABINA KHATUN | Contact No | 9163515207 |
| Address | 7 ARABINDA SARANI,CHATRA | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||