Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05261 | Date 28/05/2019 |
| Token No | SM/19-20/4487 13/06/2019 | Serial | 042 Last Visit: 13/06/2019 |
| Patient Name | Miss SAJDA PARVEEN | Contact No | 8100655097 |
| Address | RABINDRA BHABON ROAD | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||