Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 06356 | Date 07/09/2019 |
| Token No | SM/19-20/9990 07/09/2019 | Serial | 059 Last Visit: 07/09/2019 |
| Patient Name | Miss RUSHI KUMARI | Contact No | 9748572003 |
| Address | 54 CHATRA DHARMA TALA | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 23 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||