Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03978 | Date 02/03/2019 |
| Token No | SM/18-19/9779 02/03/2019 | Serial | 098 Last Visit: 02/03/2019 |
| Patient Name | Mrs. JAHEDA BIBI | Contact No | |
| Address | MORPUKUR RISHRA | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 62 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||