Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02772 | Date 31/12/2018 |
| Token No | SM/18-19/7301 22/01/2019 | Serial | 072 Last Visit: 16/07/2019 |
| Patient Name | Mrs. RESHMA BIBI | Contact No | 9830953893 |
| Address | 23/A MALLICK PARA,MEYA DARJE LANE | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||