Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 11358 | Date 28/07/2022 |
| Token No | SM/22-23/15148 28/07/2022 | Serial | 046 Last Visit: 28/07/2022 |
| Patient Name | Miss ASMA KHATOON | Contact No | 8617716366 |
| Address | 21 MUSALMAN PARA BYE LANE | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||