Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01442 | Date 01/10/2018 |
| Token No | SM/18-19/2443 04/10/2018 | Serial | 041 Last Visit: 04/10/2018 |
| Patient Name | Mrs. MEERA DEVI | Contact No | |
| Address | 54, CHATRA DHARMOTALA | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||