Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02334 | Date 04/12/2018 |
| Token No | SM/18-19/4659 04/12/2018 | Serial | 045 Last Visit: 04/12/2018 |
| Patient Name | Mrs. SALIMA BIBI | Contact No | |
| Address | CHATRA AUROBINDO SARANI | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||