Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01334 | Date 25/09/2018 |
| Token No | SM/18-19/2064 25/09/2018 | Serial | 046 Last Visit: 25/09/2018 |
| Patient Name | Mrs. GOURI DEVI | Contact No | |
| Address | RAJDHAR PUR | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||