Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02650 | Date 22/12/2018 |
| Token No | SM/18-19/8415 12/02/2019 | Serial | 019 Last Visit: 12/02/2019 |
| Patient Name | Mrs. BARSHA BEGAM | Contact No | 9874158416 |
| Address | CHATRA BOU BAJAR | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||