Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02280 | Date 01/12/2018 |
| Token No | SM/18-19/4525 01/12/2018 | Serial | 052 Last Visit: 01/12/2018 |
| Patient Name | Mrs. SABANA BEGAM | Contact No | 7044152290 |
| Address | 8, CHATRA BAJAR ROAD | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||