Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03529 | Date 12/02/2019 |
| Token No | SM/18-19/8530 12/02/2019 | Serial | 134 Last Visit: 12/02/2019 |
| Patient Name | Mrs. AFSANA BEGAM | Contact No | |
| Address | SHEWRAPHULI | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||