Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00843 | Date 30/08/2018 |
| Token No | SM/18-19/2369 03/10/2018 | Serial | 024 Last Visit: 16/07/2022 |
| Patient Name | Mrs. MIRA BEGAM | Contact No | 6291534758 |
| Address | 7B CHATRA MUSALMAN PARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 62.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||