Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01489 | Date 04/10/2018 |
| Token No | SM/18-19/2409 04/10/2018 | Serial | 007 Last Visit: 04/10/2018 |
| Patient Name | Mrs. DURGA DEVI YADAV | Contact No | 7808915267 |
| Address | BAGER BAGAN TELI PARA | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||