Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10221 | Date 23/10/2021 |
| Token No | SM/21-22/6154 23/10/2021 | Serial | 021 Last Visit: 23/10/2021 |
| Patient Name | Mrs. RAHAMATIYA NISHA | Contact No | 9693170014 |
| Address | 22 MUSA;LMAN PARA, | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||