Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06402 | Date 14/09/2019 |
| Token No | SM/19-20/13180 14/11/2019 | Serial | 007 Last Visit: 14/11/2019 |
| Patient Name | Mrs. SEHANAJ BEGAM | Contact No | 8443087179 |
| Address | 32 GANDHI SRAK RISHRA(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||