Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 04112 | Date 09/03/2019 |
| Token No | SM/18-19/10231 09/03/2019 | Serial | 022 Last Visit: 19/03/2019 |
| Patient Name | Mrs. LAKHI KHAN | Contact No | 7278115461 |
| Address | RAMKRISHNA NAGAR SANPUKUR DHAR | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||