Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02931 | Date 09/01/2019 |
| Token No | SM/18-19/6570 09/01/2019 | Serial | 059 Last Visit: 09/01/2019 |
| Patient Name | Mrs. SAJINA BIBI | Contact No | 8240289541 |
| Address | MUSALMAN PARA, CHATRA | Age | 40 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||