Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00914 | Date 04/09/2018 |
| Token No | SM/19-20/10216 12/09/2019 | Serial | 034 Last Visit: 12/09/2019 |
| Patient Name | Mrs. SOKHINA BEGAM | Contact No | 9088274168 |
| Address | 15, CHATRA MUSALMAN PARA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||