Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01173 | Date 15/09/2018 |
| Token No | SM/18-19/2057 25/09/2018 | Serial | 039 Last Visit: 28/02/2019 |
| Patient Name | Mrs. AJMERI BIBI | Contact No | 8910284667 |
| Address | 56 RAY GHAT LANE | Age | 26 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||