Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02129 | Date 26/11/2018 |
| Token No | SM/18-19/4170 26/11/2018 | Serial | 043 Last Visit: 26/11/2018 |
| Patient Name | Mrs. RABIYA BIBI | Contact No | 9088358818 |
| Address | BARO BELU KALTALA | Age | 43 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||