Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02029 | Date 19/11/2018 |
| Token No | SM/18-19/3867 19/11/2018 | Serial | 034 Last Visit: 02/02/2019 |
| Patient Name | Mrs. RIJIYA BEGAM | Contact No | 7044682962 |
| Address | CHATRA MUSALMAN PARA | Age | 56 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||