Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05248 | Date 27/05/2019 |
| Token No | SM/19-20/3939 03/06/2019 | Serial | 062 Last Visit: 03/06/2019 |
| Patient Name | Miss SANIYA KHATUN | Contact No | 9903943603 |
| Address | RAMCHANDRA PUR DIARA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||