Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04948 | Date 27/04/2019 |
| Token No | SM/19-20/15032 11/12/2019 | Serial | 011 Last Visit: 11/12/2019 |
| Patient Name | Mrs. SULEKHA DHARA | Contact No | 9836995545 |
| Address | MOLLA SIMLA NASIBPUR | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||