Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05186 | Date 21/05/2019 |
| Token No | SM/19-20/3200 22/05/2019 | Serial | 041 Last Visit: 24/05/2019 |
| Patient Name | Mrs. JAYASHREE MALIK | Contact No | 7890577943 |
| Address | MOHOMAD PUR,DIYARA | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||