Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06633 | Date 14/10/2019 |
| Token No | SM/19-20/11692 14/10/2019 | Serial | 086 Last Visit: 14/10/2019 |
| Patient Name | Mrs. KAMALA DULEY | Contact No | |
| Address | CHOUTARA,KAIKALA | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||