Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08438 | Date 27/06/2020 |
| Token No | SM/22-23/14347 06/07/2022 | Serial | 004 Last Visit: 18/07/2022 |
| Patient Name | Miss RUKSA KHATOON | Contact No | 7449983889 |
| Address | 4/A MUSALMAN PARA BYE LANE SERAMPORE | Age | 12 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||