Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03189 | Date 25/01/2019 |
| Token No | SM/18-19/7471 25/01/2019 | Serial | 061 Last Visit: 31/01/2019 |
| Patient Name | Mrs. ANOWARA BEGAM | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||