Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03267 | Date 31/01/2019 |
| Token No | SM/18-19/7710 31/01/2019 | Serial | 084 Last Visit: 31/01/2019 |
| Patient Name | Mrs. DURGA RANI PANDEY | Contact No | 8697302879 |
| Address | 4 L B S ROAD | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||