Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06172 | Date 20/08/2019 |
| Token No | SM/19-20/9254 27/08/2019 | Serial | 062 Last Visit: 28/08/2019 |
| Patient Name | Mrs. MADHURI JAISWARA | Contact No | 7449784201 |
| Address | RAJARAM, HASANPUR TAINI, MALIKPUR NONARA, SULTANPUR , KADIPUR, UTTAR PARDESH-228145 | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||