Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00999 | Date 08/09/2018 |
| Token No | SM/18-19/1399 08/09/2018 | Serial | 028 Last Visit: 08/09/2018 |
| Patient Name | Mrs. RAJESWARI MAJHI | Contact No | 9836041207 |
| Address | 54 BARO BAGAN | Age | 8.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||