Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05029 | Date 07/05/2019 |
| Token No | SM/19-20/2293 07/05/2019 | Serial | 074 Last Visit: 07/05/2019 |
| Patient Name | Mrs. RUKSANA BIBI | Contact No | 9831885141 |
| Address | CHATRA KUMAR PARA ARBINDA SARANI | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||