Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00275 | Date 09/08/2018 |
| Token No | SM/18-19/298 09/08/2018 | Serial | 029 Last Visit: 09/08/2018 |
| Patient Name | Mrs. MURSHIDA BEGAM | Contact No | 933144867 |
| Address | 9, CHATRA ARBINDO SARANI | Age | 19.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 90/60 mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||