Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03676 | Date 18/02/2019 |
| Token No | SM/18-19/10195 08/03/2019 | Serial | 086 Last Visit: 15/06/2019 |
| Patient Name | Mrs. PINKI DAS | Contact No | 7044773658 |
| Address | CHATRA MUSALMAN PARA SHEWRAPHULI | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||