Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02292 | Date 03/12/2018 |
| Token No | SM/18-19/4555 03/12/2018 | Serial | 021 Last Visit: 17/04/2019 |
| Patient Name | Mrs. NASHIBUN BIBI | Contact No | 8479042100 |
| Address | SHAORAPHULY | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||