Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03016 | Date 15/01/2019 |
| Token No | SM/19-20/6226 10/07/2019 | Serial | 094 Last Visit: 10/07/2019 |
| Patient Name | Mrs. PUNAM JAISWAL | Contact No | 9007802548 |
| Address | 18 RABINDRA BHABAN ROAD | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||