Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 02527 | Date 14/12/2018 |
| Token No | SM/18-19/6036 31/12/2018 | Serial | 035 Last Visit: 23/05/2019 |
| Patient Name | Mrs. ANIMA NATH | Contact No | |
| Address | CHATRA GODER BAGAN | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||