Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06086 | Date 07/08/2019 |
| Token No | SM/19-20/8133 07/08/2019 | Serial | 076 Last Visit: 07/08/2019 |
| Patient Name | Mrs. MOMTARA BIBI | Contact No | 9062551945 |
| Address | CHATRA KUMAR PARA | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||