Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06399 | Date 13/09/2019 |
| Token No | SM/19-20/10302 13/09/2019 | Serial | 032 Last Visit: 13/09/2019 |
| Patient Name | Mrs. GULJARA | Contact No | 9748688950 |
| Address | 15 KAPURIYA PATTI LANE , TINBAJAR SERAMPORE | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||