Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02991 | Date 14/01/2019 |
| Token No | SM/20-21/26860 19/10/2020 | Serial | 071 Last Visit: 10/11/2020 |
| Patient Name | Mrs. SAHINA BEGUM | Contact No | 9051672355 |
| Address | 18 MUSALMAN PARA, CHATRA | Age | 34 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||