Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04942 | Date 27/04/2019 |
| Token No | SM/19-20/1808 27/04/2019 | Serial | 057 Last Visit: 27/04/2019 |
| Patient Name | Mrs. TUKTUKI BEGAM | Contact No | 9062089904 |
| Address | CHATRA MUSALMAN PARA | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||