Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01448 | Date 01/10/2018 |
| Token No | SM/18-19/10770 18/03/2019 | Serial | 069 Last Visit: 03/09/2019 |
| Patient Name | Mrs. REZIA BEGAM | Contact No | 7044921621 |
| Address | 33, CHATRA MUSALMAN PARA / LANE | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||