Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02700 | Date 27/12/2018 |
| Token No | SM/18-19/5814 27/12/2018 | Serial | 072 Last Visit: 27/12/2018 |
| Patient Name | Mrs. LAL MUNI BIBI | Contact No | 8100149716 |
| Address | 5 PARSHI LANE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||