Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05957 | Date 25/07/2019 |
| Token No | SM/19-20/7318 25/07/2019 | Serial | 071 Last Visit: 25/07/2019 |
| Patient Name | Miss SOHANA AJMI | Contact No | 9674253720 |
| Address | 3 MUSALMAN PARA BYE LANE CHATRA SERAMPORE | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||