Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05770 | Date 15/07/2019 |
| Token No | SM/19-20/6467 15/07/2019 | Serial | 010 Last Visit: 15/07/2019 |
| Patient Name | Mrs. TANUJA BEGUM | Contact No | 9874066615 |
| Address | 3 CHATRA MUSALMAN PARA | Age | 23 Y Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||