Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02915 | Date 09/01/2019 |
| Token No | SM/18-19/7632 31/01/2019 | Serial | 006 Last Visit: 06/11/2019 |
| Patient Name | Mrs. RINA BEGAM | Contact No | 9874158416 |
| Address | CHATRA BOU BAZAR | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||