Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08071 | Date 13/04/2020 |
| Token No | SM/19-20/21062 13/04/2020 | Serial | 030 Last Visit: 13/07/2020 |
| Patient Name | Mrs. SOMA BEGAM | Contact No | 798064858 |
| Address | 43 CHATRA MUSALMAN PARA | Age | 24 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||