Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09645 | Date 24/05/2021 |
| Token No | SM/21-22/5207 18/09/2021 | Serial | 019 Last Visit: 18/09/2021 |
| Patient Name | Mrs. MADINA KHATOON | Contact No | 9875370885 |
| Address | MAJHAR GOYALA PARA , CHAMPDANI (M) | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||