Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 10423 | Date 16/12/2021 |
| Token No | SM/21-22/7809 16/12/2021 | Serial | 002 Last Visit: 21/12/2021 |
| Patient Name | Mrs. KUSALLYA HARI | Contact No | |
| Address | GITEN LEHIRI ROAD, | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | 150 cm BMI: 26.666667 |
| Diagnosis | |||