Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07961 | Date 30/03/2020 |
| Token No | SM/20-21/29518 19/01/2021 | Serial | 012 Last Visit: 19/01/2021 |
| Patient Name | Miss SHAMA PARVEEN | Contact No | 8013702481 |
| Address | 12 A. B. ROAD RISHRA M | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||