Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01530 | Date 05/10/2018 |
| Token No | SM/18-19/2508 05/10/2018 | Serial | 029 Last Visit: 05/10/2018 |
| Patient Name | Mrs. SALIMA KHATUN | Contact No | |
| Address | SEORAFULI,M T ROAD | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||