Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02974 | Date 11/01/2019 |
| Token No | SM/18-19/6709 11/01/2019 | Serial | 066 Last Visit: 11/01/2019 |
| Patient Name | Mrs. SANTI ROY | Contact No | 9674469292 |
| Address | 18 N N ROY STREET | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||