Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02760 | Date 31/12/2018 |
| Token No | SM/18-19/6048 31/12/2018 | Serial | 047 Last Visit: 05/02/2019 |
| Patient Name | Mrs. KAMLA DEBI | Contact No | 7003216460 |
| Address | 10 M G ROAD | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||