Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00342 | Date 11/08/2018 |
| Token No | SM/18-19/3660 14/11/2018 | Serial | 049 Last Visit: 19/08/2019 |
| Patient Name | Mrs. UMA PALODHI | Contact No | 7278736439 |
| Address | 21, CHATRA CHOWDHRY PARA BYE LANE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||