Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02653 | Date 22/12/2018 |
| Token No | SM/19-20/14827 06/12/2019 | Serial | 084 Last Visit: 30/07/2020 |
| Patient Name | Mrs. KAMLA BALA SINGH | Contact No | 9051170601 |
| Address | 33, P.N MUKHERJEE STREET | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||