Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04012 | Date 05/03/2019 |
| Token No | SM/18-19/9871 05/03/2019 | Serial | 072 Last Visit: 03/03/2021 |
| Patient Name | Mrs. ANJURA BIBI | Contact No | 9073429385 |
| Address | 9 ARBINDA SARANI CHATRA MUSALMAN PARA | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||