Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02137 | Date 26/11/2018 |
| Token No | SM/18-19/4985 10/12/2018 | Serial | 033 Last Visit: 23/10/2019 |
| Patient Name | Mrs. HAJERA BIBI | Contact No | 8585878581 |
| Address | 4CHILEKHARA ROAD,MALLIK PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||