Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08551 | Date 17/07/2020 |
| Token No | SM/19-20/24185 17/07/2020 | Serial | 036 Last Visit: 18/08/2020 |
| Patient Name | Miss SONAM KHATOON | Contact No | 8478085778 |
| Address | 19 KANHAI DEWAN TALA LANE SERAMPORE | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||