Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01896 | Date 05/11/2018 |
| Token No | SM/18-19/3734 15/11/2018 | Serial | 029 Last Visit: 15/11/2018 |
| Patient Name | Mrs. NURMAHAN BIBI | Contact No | 7450878995 |
| Address | SEORAPHULI JAMINDAR ROAD | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 79 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||