Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03232 | Date 30/01/2019 |
| Token No | SM/18-19/7666 31/01/2019 | Serial | 040 Last Visit: 01/02/2019 |
| Patient Name | Mrs. EBADON BIBI | Contact No | 9007733611 |
| Address | 9 CHATRA ,ARABINDA SARANI | Age | 55 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||