Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04512 | Date 02/04/2019 |
| Token No | SM/19-20/13524 19/11/2019 | Serial | 021 Last Visit: 19/11/2019 |
| Patient Name | Mrs. SHALU SHRIVASTAVA | Contact No | 7003942160 |
| Address | 38/4/1, N.S AVENUE ,RISHRA (M) | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||