Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02231 | Date 30/11/2018 |
| Token No | SM/18-19/4417 30/11/2018 | Serial | 006 Last Visit: 30/11/2018 |
| Patient Name | Mrs. SAJRA BIBI | Contact No | |
| Address | CHATRA ARBINDA SARANI | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||