Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05773 | Date 15/07/2019 |
| Token No | SM/19-20/6489 15/07/2019 | Serial | 032 Last Visit: 15/07/2019 |
| Patient Name | Mrs. SUMAN KUMARI SINGH | Contact No | 9051464710 |
| Address | P.K BISWAS ROAD KHARDA TITAGARH(M) | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||