Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06167 | Date 20/08/2019 |
| Token No | SM/19-20/8782 20/08/2019 | Serial | 061 Last Visit: 20/08/2019 |
| Patient Name | Mrs. SABIA BEGUM | Contact No | 8820366821 |
| Address | 18/3 P.B.M BYE LANE CHAMPDANI (M) | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||