Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01273 | Date 22/09/2018 |
| Token No | SM/18-19/10936 20/03/2019 | Serial | 041 Last Visit: 20/03/2019 |
| Patient Name | Mrs. ROSHNA KHATUN | Contact No | 9232501856 |
| Address | SEORAPHULYY,CHATRA MUSALMAN PARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||