Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00512 | Date 17/08/2018 |
| Token No | SM/18-19/2004 24/09/2018 | Serial | 063 Last Visit: 07/10/2019 |
| Patient Name | Mrs. RUBINA BIBI | Contact No | 9007755751 |
| Address | 4/A ARBINDO SARNI , CHATRA | Age | 30.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||