Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05839 | Date 19/07/2019 |
| Token No | SM/19-20/8590 19/08/2019 | Serial | 044 Last Visit: 02/09/2019 |
| Patient Name | Mrs. KAMALA DHARA | Contact No | 8647005037 |
| Address | MOLLASIMLA,NASHIBPUR | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||