Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05703 | Date 08/07/2019 |
| Token No | SM/19-20/6084 08/07/2019 | Serial | 057 Last Visit: 08/07/2019 |
| Patient Name | Mrs. SARNALI SIL | Contact No | |
| Address | MILLAN COLONY | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||