Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09746 | Date 24/06/2021 |
| Token No | SM/21-22/2504 24/06/2021 | Serial | 005 Last Visit: 24/06/2021 |
| Patient Name | Miss SITARA PARVEEN | Contact No | 9007357058 |
| Address | 11/B T.C. GOSWAMI STREET | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||