Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06300 | Date 02/09/2019 |
| Token No | SM/19-20/10888 23/09/2019 | Serial | 015 Last Visit: 23/09/2019 |
| Patient Name | Mrs. CHANDU BARIK | Contact No | 9748849248 |
| Address | MOLLASIMLA , MOLLASIMLA, NASIBPUR | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||