Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01597 | Date 10/10/2018 |
| Token No | SM/18-19/11549 29/03/2019 | Serial | 057 Last Visit: 10/07/2019 |
| Patient Name | Mrs. JHARNA KHETRA PAL | Contact No | |
| Address | ROY GHAT LANE | Age | 67 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 42 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||