Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02940 | Date 10/01/2019 |
| Token No | SM/18-19/6597 10/01/2019 | Serial | 024 Last Visit: 08/02/2019 |
| Patient Name | Mrs. SUKANTALA GUPTA | Contact No | 9836798947 |
| Address | TETUL TALA CHATRA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||