Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01326 | Date 25/09/2018 |
| Token No | SM/18-19/2047 25/09/2018 | Serial | 029 Last Visit: 25/09/2018 |
| Patient Name | Mrs. MAJEDA BEGAM | Contact No | |
| Address | CHATRA KUMAR PARA | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||