Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00494 | Date 16/08/2018 |
| Token No | SM/18-19/556 16/08/2018 | Serial | 044 Last Visit: 16/08/2018 |
| Patient Name | Mrs. MARIYA KHATOON | Contact No | 7890818112 |
| Address | CHATRA M.P | Age | 7.0 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||