Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03287 | Date 01/02/2019 |
| Token No | SM/18-19/7775 01/02/2019 | Serial | 051 Last Visit: 01/02/2019 |
| Patient Name | Mrs. SAJAHAN BEGAM | Contact No | |
| Address | 16/B RABINDRA BHOBON ROAD | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||