Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05622 | Date 29/06/2019 |
| Token No | SM/19-20/8929 21/08/2019 | Serial | 091 Last Visit: 14/09/2019 |
| Patient Name | Mrs. SAKILA BEGUM | Contact No | 9748706309 |
| Address | 34/3 GANDHI SARAK,RISHRA | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||