Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00105 | Date 04/08/2018 |
| Token No | SM/18-19/5752 27/12/2018 | Serial | 010 Last Visit: 13/06/2020 |
| Patient Name | Mrs. MONU BIBI | Contact No | 6289366469 |
| Address | CHATARA MUSALMAN PARA | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||