Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06897 | Date 18/11/2019 |
| Token No | SM/19-20/13491 18/11/2019 | Serial | 066 Last Visit: 18/11/2019 |
| Patient Name | Mrs. SUPERVISOR 1 | Contact No | 7998216605 |
| Address | BAGH LANE WARD 1 MALLIKA DI | Age | 44 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||