Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09037 | Date 09/12/2020 |
| Token No | SM/20-21/28269 09/12/2020 | Serial | 025 Last Visit: 09/12/2020 |
| Patient Name | Miss SHERYA JHA | Contact No | 7003856876 |
| Address | K C SEN ROAD MOREPUKUR RISHRA | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||