Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 13430 | Date 11/03/2024 |
| Token No | SM/22-23/30199 11/03/2024 | Serial | 096 Last Visit: 11/03/2024 |
| Patient Name | Miss ASHNA GHORUY | Contact No | |
| Address | 12/C KUMIRJALA ROAD | Age | 10 Years,2 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||