Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04619 | Date 08/04/2019 |
| Token No | SM/19-20/496 08/04/2019 | Serial | 060 Last Visit: 08/04/2019 |
| Patient Name | Miss SABA AFRIA | Contact No | 8981400738 |
| Address | 32 GANDHI SARAK,RISHRA(M) | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||