Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06147 | Date 19/08/2019 |
| Token No | SM/19-20/8592 19/08/2019 | Serial | 046 Last Visit: 10/01/2020 |
| Patient Name | Mrs. SHILA BARIK | Contact No | 9748512224 |
| Address | MOLLASIMLA, NASIBPUR | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||