Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01603 | Date 10/10/2018 |
| Token No | SM/18-19/11340 27/03/2019 | Serial | 044 Last Visit: 27/03/2019 |
| Patient Name | Mrs. RUPA BEGAM | Contact No | 9748931169 |
| Address | CHATRA MUSALMAN PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||