Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00807 | Date 29/08/2018 |
| Token No | SM/18-19/1014 29/08/2018 | Serial | 020 Last Visit: 29/08/2018 |
| Patient Name | Mrs. AFSANA BIBI | Contact No | 7449961793 |
| Address | 18/1 CHATRA MUSALMAN PARA BY LANE | Age | 18.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 103/60 mmHg | Weight | 38 KG |
| Pulse Rate | 150 / min | Height | cm BMI: inf |
| Diagnosis | |||