Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02377 | Date 06/12/2018 |
| Token No | SM/18-19/6425 07/01/2019 | Serial | 079 Last Visit: 14/01/2019 |
| Patient Name | Mrs. MAJRA BEGAM | Contact No | 9051672355 |
| Address | 18, CHATRA MUSALMAN PARA /LANE | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||