Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03646 | Date 18/02/2019 |
| Token No | SM/18-19/8886 18/02/2019 | Serial | 059 Last Visit: 18/02/2019 |
| Patient Name | Mrs. NAIMA BEWA | Contact No | |
| Address | 26/1 MALLIK PARA | Age | 75 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 150/90 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||