Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04511 | Date 02/04/2019 |
| Token No | SM/19-20/17514 03/02/2020 | Serial | 044 Last Visit: 03/02/2020 |
| Patient Name | Mrs. SK JHARNA | Contact No | 7449935695 |
| Address | 41 CHATRA MUSALMAN PARA | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||