Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05732 | Date 11/07/2019 |
| Token No | SM/19-20/6270 11/07/2019 | Serial | 020 Last Visit: 11/07/2019 |
| Patient Name | Mrs. HALIMA BIBI | Contact No | 8478953945 |
| Address | 28 CHILEKHALA ROAD,MALLICK PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||