Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03241 | Date 30/01/2019 |
| Token No | SM/18-19/7624 30/01/2019 | Serial | 054 Last Visit: 18/02/2019 |
| Patient Name | Mrs. KASMIRA BIBI | Contact No | |
| Address | MALLICK PARA,MIYAJON DARJILANE | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||