Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04137 | Date 09/03/2019 |
| Token No | SM/18-19/10289 09/03/2019 | Serial | 080 Last Visit: 09/03/2019 |
| Patient Name | Mrs. MINA BIBI | Contact No | 7890084199 |
| Address | 5 CHATRA ARBINDA SARANI | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||