Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08462 | Date 02/07/2020 |
| Token No | SM/19-20/23642 02/07/2020 | Serial | 051 Last Visit: 02/07/2020 |
| Patient Name | Mrs. CHANPA SOM | Contact No | 8481809923 |
| Address | PAHALAMPUR , DIARA | Age | 39 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||