Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02710 | Date 28/12/2018 |
| Token No | SM/18-19/5874 28/12/2018 | Serial | 016 Last Visit: 28/12/2018 |
| Patient Name | Mrs. NAJMA BEGAM | Contact No | 8697619357 |
| Address | 13 CHATRA MUSALMAN PARA BY LANE | Age | 60 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | 160/86 mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||