Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04012 | Date 05/03/2019 |
| Token No | SM/20-21/30312 03/03/2021 | Serial | 021 Last Visit: 03/03/2021 |
| Patient Name | Mrs. ANJURA BIBI | Contact No | 9073429385 |
| Address | 9 ARBINDA SARANI CHATRA MUSALMAN PARA | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||