Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00915 | Date 04/09/2018 |
| Token No | SM/18-19/1222 04/09/2018 | Serial | 058 Last Visit: 13/09/2018 |
| Patient Name | Mrs. HASINA BEGAM | Contact No | |
| Address | 15 CHATRA MUSALMAN PARA | Age | 35.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 98/68 mmHg | Weight | 52 KG |
| Pulse Rate | 92 / min | Height | cm BMI: inf |
| Diagnosis | |||