Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 05638 | Date 02/07/2019 |
| Token No | SM/19-20/5730 02/07/2019 | Serial | 020 Last Visit: 02/07/2019 |
| Patient Name | Mrs. MODHUSUDAN BHOLLA | Contact No | 8017245197 |
| Address | 61 N. N. ROY STREET | Age | 60 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||