Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 02618 | Date 20/12/2018 |
| Token No | SM/18-19/5849 27/12/2018 | Serial | 107 Last Visit: 27/12/2018 |
| Patient Name | Mrs. RENU DEY | Contact No | 9830406493 |
| Address | 175 NEHURI NAGER KOLONI | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||