Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04545 | Date 04/04/2019 |
| Token No | SM/19-20/239 04/04/2019 | Serial | 028 Last Visit: 04/04/2019 |
| Patient Name | Miss JUMMA KHATUN | Contact No | 9163189170 |
| Address | PAMPA NAGAR | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||