Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 02485 | Date 12/12/2018 |
| Token No | SM/18-19/5131 12/12/2018 | Serial | 045 Last Visit: 12/12/2018 |
| Patient Name | Mrs. PURNIMA GUPTA | Contact No | 8479932539 |
| Address | RAMKRISHNAGAR NICHUMATH | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||