Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02031 | Date 19/11/2018 |
| Token No | SM/18-19/4177 26/11/2018 | Serial | 050 Last Visit: 11/01/2019 |
| Patient Name | Mrs. SALIMA BEGAM | Contact No | 9051672355 |
| Address | 18,CHATRA MUSALMANPARA/LANE | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||