Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02513 | Date 13/12/2018 |
| Token No | SM/18-19/5197 13/12/2018 | Serial | 044 Last Visit: 13/12/2018 |
| Patient Name | Mrs. LAXMI HARI | Contact No | |
| Address | MAHESH BONGALAXMI | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||