Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06580 | Date 30/09/2019 |
| Token No | SM/19-20/11318 30/09/2019 | Serial | 043 Last Visit: 30/09/2019 |
| Patient Name | Mrs. AYAN RAJA | Contact No | 9903902463 |
| Address | TINBAZAR, KOTIBASA | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||