Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00870 | Date 31/08/2018 |
| Token No | SM/18-19/1126 31/08/2018 | Serial | 040 Last Visit: 31/08/2018 |
| Patient Name | Mrs. CHHOBI SHEE | Contact No | |
| Address | RISHRA, RISHRA M | Age | 62.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||