Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03833 | Date 23/02/2019 |
| Token No | SM/19-20/13240 14/11/2019 | Serial | 067 Last Visit: 28/02/2020 |
| Patient Name | Mrs. MODINA BIBI | Contact No | 6291707443 |
| Address | CHATRA KUMARA BY LANE | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||