Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02828 | Date 04/01/2019 |
| Token No | SM/18-19/9379 23/02/2019 | Serial | 065 Last Visit: 30/11/2019 |
| Patient Name | Mrs. MURJINA BIBI | Contact No | |
| Address | BARO BELUR KAL TALA | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||