Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 06823 | Date 09/11/2019 |
| Token No | SM/19-20/12935 09/11/2019 | Serial | 013 Last Visit: 09/11/2019 |
| Patient Name | Mrs. KARABI PYNE | Contact No | |
| Address | 15 BINIOPARA | Age | 54 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||