Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 01126 | Date 14/09/2018 |
| Token No | SM/19-20/21482 23/04/2020 | Serial | 029 Last Visit: 12/06/2020 |
| Patient Name | Mrs. SUNARPATI DEVI | Contact No | 7003388692 |
| Address | 121 R B SARANI | Age | 52.0 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||