Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05554 | Date 24/06/2019 |
| Token No | SM/19-20/5241 24/06/2019 | Serial | 107 Last Visit: 24/06/2019 |
| Patient Name | Mrs. LANGA PASOAN | Contact No | |
| Address | GOYALAPARA, | Age | 85 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||