Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07108 | Date 09/12/2019 |
| Token No | SM/19-20/15255 14/12/2019 | Serial | 020 Last Visit: 02/01/2020 |
| Patient Name | Mrs. SUMAN KUMARI RAM | Contact No | 9051464710 |
| Address | 23,CHATU GANGE,SEORAPHULI | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||