Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00509 | Date 17/08/2018 |
| Token No | SM/19-20/12547 31/10/2019 | Serial | 068 Last Visit: 31/10/2019 |
| Patient Name | Mrs. AISA BIBI | Contact No | 9007755751 |
| Address | 4/A ARBINDO SARNI , CHATRA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||