Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00818 | Date 29/08/2018 |
| Token No | SM/18-19/1264 05/09/2018 | Serial | 040 Last Visit: 29/09/2018 |
| Patient Name | Mrs. NUR BANU | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||