Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07477 | Date 05/02/2020 |
| Token No | SM/19-20/17645 05/02/2020 | Serial | 021 Last Visit: 05/02/2020 |
| Patient Name | Miss SULTANA BEGAM | Contact No | 9432222597 |
| Address | 41 MUSALMAN PARA ROAD | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||