Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05834 | Date 19/07/2019 |
| Token No | SM/19-20/6827 19/07/2019 | Serial | 017 Last Visit: 19/07/2019 |
| Patient Name | Mrs. PINKI HARI | Contact No | 7595029030 |
| Address | 19 BAZAR BEY LANE, | Age | 20 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||