Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00647 | Date 23/08/2018 |
| Token No | SM/19-20/2817 15/05/2019 | Serial | 057 Last Visit: 27/01/2020 |
| Patient Name | Mrs. ALPANA KOYAL | Contact No | 6291856959 |
| Address | 82, BARUI PARA LANE CHATRA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||