Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00819 | Date 29/08/2018 |
| Token No | SM/19-20/447 08/04/2019 | Serial | 011 Last Visit: 10/07/2019 |
| Patient Name | Mrs. NASIMA BEGAM | Contact No | 9088739243 |
| Address | CHATRA MUSALMAN PARA | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 38 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||