Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02482 | Date 12/12/2018 |
| Token No | SM/18-19/5123 12/12/2018 | Serial | 037 Last Visit: 25/03/2019 |
| Patient Name | Mrs. MUSRAT BEGAM | Contact No | 6289106294 |
| Address | BOROBELU KOLTALA | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||