Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02145 | Date 27/11/2018 |
| Token No | SM/19-20/5899 05/07/2019 | Serial | 062 Last Visit: 10/07/2021 |
| Patient Name | Mrs. MANWARA BEGAM | Contact No | 9874463025 |
| Address | 50, CHATRA MUSALMAN PARA ROAD | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||