Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05857 | Date 19/07/2019 |
| Token No | SM/19-20/6887 19/07/2019 | Serial | 077 Last Visit: 19/07/2019 |
| Patient Name | Mrs. KALPANA ADHIKARY | Contact No | 8820644612 |
| Address | DASPARA, DAKSHIN RAJYADHARPUR | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||