Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 02882 | Date 07/01/2019 |
| Token No | SM/18-19/9385 23/02/2019 | Serial | 071 Last Visit: 08/03/2019 |
| Patient Name | Mrs. CHABI CHANDRA | Contact No | 7003053688 |
| Address | 61 N.N. RAY STREET | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||