Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02773 | Date 31/12/2018 |
| Token No | SM/19-20/5009 21/06/2019 | Serial | 035 Last Visit: 27/02/2020 |
| Patient Name | Mrs. ANWARA BEGAM | Contact No | 9830953893 |
| Address | 23/A MALLICK PARA ,MEYA DARJI LANE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||