Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03172 | Date 25/01/2019 |
| Token No | SM/18-19/7726 01/02/2019 | Serial | 002 Last Visit: 21/10/2020 |
| Patient Name | Mrs. KORAYSHA BEGAM | Contact No | |
| Address | 11 PARSI LANE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||