Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 08213 | Date 04/05/2020 |
| Token No | SM/19-20/21915 04/05/2020 | Serial | 059 Last Visit: 06/05/2020 |
| Patient Name | Mrs. KAKHI KAYAL | Contact No | |
| Address | 65 CHATRA DHARMA LATA, | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||