Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05375 | Date 10/06/2019 |
| Token No | SM/19-20/4306 10/06/2019 | Serial | 088 Last Visit: 10/06/2019 |
| Patient Name | Mrs. SALELA KHATUN | Contact No | |
| Address | RISHRA | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||