Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04010 | Date 05/03/2019 |
| Token No | SM/18-19/9869 05/03/2019 | Serial | 070 Last Visit: 05/03/2019 |
| Patient Name | Mrs. NILUPA BEGAM | Contact No | 9073429385 |
| Address | THAKUR HAT BORA | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||