Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02003 | Date 16/11/2018 |
| Token No | SM/18-19/7237 22/01/2019 | Serial | 008 Last Visit: 23/09/2025 |
| Patient Name | Mrs. AJMIRA BEGAM | Contact No | 9073502833 |
| Address | 5/A/2 CHATRA MUSALMAN PARA | Age | 51 Years,8 Months,21 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||