Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04305 | Date 19/03/2019 |
| Token No | SM/18-19/10886 19/03/2019 | Serial | 079 Last Visit: 01/10/2020 |
| Patient Name | Mrs. HASINA BANU | Contact No | |
| Address | 23 PARSHI LANE,SIL BAGAN | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||