Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01114 | Date 13/09/2018 |
| Token No | SM/18-19/1623 13/09/2018 | Serial | 046 Last Visit: 13/09/2018 |
| Patient Name | Mrs. SUNITA DOM | Contact No | 8017648277 |
| Address | 115/A RB SARANI | Age | 38.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 104/68 mmHg | Weight | 60 KG |
| Pulse Rate | 79 / min | Height | cm BMI: inf |
| Diagnosis | |||