Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07122 | Date 11/12/2019 |
| Token No | SM/19-20/15052 11/12/2019 | Serial | 031 Last Visit: 11/12/2019 |
| Patient Name | Mrs. PUSHPANJALI DAS | Contact No | 9051884430 |
| Address | MALLASIMLA,DEARA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||