Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08168 | Date 28/04/2020 |
| Token No | SM/19-20/21701 29/04/2020 | Serial | 020 Last Visit: 05/05/2020 |
| Patient Name | Mrs. PUTUL SINGH | Contact No | 9123941456 |
| Address | 6 RAMSITA LANE NAYABAGAN | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||