Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02191 | Date 28/11/2018 |
| Token No | SM/18-19/4339 28/11/2018 | Serial | 071 Last Visit: 01/08/2019 |
| Patient Name | Mrs. MUSLIMA BIBI | Contact No | |
| Address | CHATRA KUMAR PARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||