Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08308 | Date 04/06/2020 |
| Token No | SM/19-20/22759 04/06/2020 | Serial | 044 Last Visit: 04/06/2020 |
| Patient Name | Miss DISHA SHAW | Contact No | 9836632170 |
| Address | 11 G.T ROAD CHAMPA ROAD, RISHRA | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||