Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00685 | Date 25/08/2018 |
| Token No | SM/18-19/4788 06/12/2018 | Serial | 043 Last Visit: 22/08/2019 |
| Patient Name | Mrs. NARGIS BEGAM | Contact No | 9051672355 |
| Address | 18,CHATRA MUSALMANPARA/LANE | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||