Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02037 | Date 19/11/2018 |
| Token No | SM/18-19/3897 19/11/2018 | Serial | 064 Last Visit: 19/11/2018 |
| Patient Name | Mrs. RIJIYA BIBI | Contact No | 9051867258 |
| Address | 83, MALLIK PARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||