Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10044 | Date 04/09/2021 |
| Token No | SM/21-22/4751 04/09/2021 | Serial | 020 Last Visit: 04/09/2021 |
| Patient Name | Miss SHARBANI SANS | Contact No | 7501830571 |
| Address | BAKSA,CHANDITALA, | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||