Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03645 | Date 18/02/2019 |
| Token No | SM/18-19/8884 18/02/2019 | Serial | 057 Last Visit: 18/02/2019 |
| Patient Name | Mrs. ANWARA BEGAM | Contact No | |
| Address | 26A MIAJAN DARJI LANE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||