Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06034 | Date 01/08/2019 |
| Token No | SM/19-20/7764 01/08/2019 | Serial | 095 Last Visit: 05/08/2019 |
| Patient Name | Mrs. GITA RAJBHAR | Contact No | 9831165762 |
| Address | 27 BAJAR BYE LANE TINBAJAR | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||