Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 02489 | Date 12/12/2018 |
| Token No | SM/18-19/7191 21/01/2019 | Serial | 059 Last Visit: 22/02/2019 |
| Patient Name | Mrs. SALLU BIBI | Contact No | |
| Address | 28 LIBARY LANE | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||