Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01748 | Date 29/10/2018 |
| Token No | SM/18-19/5367 17/12/2018 | Serial | 048 Last Visit: 28/12/2020 |
| Patient Name | Mrs. SALMA BEGAM | Contact No | 9088399717 |
| Address | CHATRA KUMAR PARA | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||