Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04239 | Date 15/03/2019 |
| Token No | SM/18-19/10602 15/03/2019 | Serial | 095 Last Visit: 15/03/2019 |
| Patient Name | Mrs. SURATAN BIBI | Contact No | 7044717120 |
| Address | CHATRA MUSALMAN PARA | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 160/90 mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||