Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 03193 | Date 25/01/2019 |
| Token No | SM/18-19/7486 25/01/2019 | Serial | 076 Last Visit: 25/01/2019 |
| Patient Name | Mrs. MANGOLA JANA | Contact No | 9231878106 |
| Address | CHARA BAGAN,BAURE PARA | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||