Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10276 | Date 15/11/2021 |
| Token No | SM/21-22/9712 09/02/2022 | Serial | 004 Last Visit: 09/02/2022 |
| Patient Name | Mrs. RIZWANA KHATOON | Contact No | 9836854602 |
| Address | 14,R.N SHAW ROAD RISHRA | Age | 28 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||