Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00111 | Date 04/08/2018 |
| Token No | SM/18-19/3400 03/11/2018 | Serial | 013 Last Visit: 20/04/2020 |
| Patient Name | Mrs. KRISHANA DHARA | Contact No | 8961605990 |
| Address | 6, SHANI PARA | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||