Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01400 | Date 28/09/2018 |
| Token No | SM/18-19/2624 09/10/2018 | Serial | 013 Last Visit: 09/10/2018 |
| Patient Name | Mrs. KOHINUR BIBI | Contact No | |
| Address | KUMAR PARA CHATRA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||