Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03452 | Date 08/02/2019 |
| Token No | SM/18-19/9637 01/03/2019 | Serial | 012 Last Visit: 01/04/2019 |
| Patient Name | Mrs. NURBANU BIBI | Contact No | 9836030945 |
| Address | 5/A/1 CHATRA MUSALMANPARA BY LANE,98360 | Age | 50.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||