Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00825 | Date 29/08/2018 |
| Token No | SM/18-19/1220 04/09/2018 | Serial | 056 Last Visit: 13/09/2018 |
| Patient Name | Mrs. MONOARA BIBI | Contact No | |
| Address | 3/1 CHATRA MUSALMAN PARA | Age | 35.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 34 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||