Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 02414 | Date 08/12/2018 |
| Token No | SM/18-19/4896 08/12/2018 | Serial | 023 Last Visit: 08/12/2018 |
| Patient Name | Mrs. TAMIM BIBI | Contact No | 9883633422 |
| Address | 19, TC GOSWAMI STREET | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||