Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01105 | Date 13/09/2018 |
| Token No | SM/18-19/1612 13/09/2018 | Serial | 035 Last Visit: 29/09/2018 |
| Patient Name | Mrs. SABANA KAHTUN | Contact No | 8100239528 |
| Address | 4, PARSI LANE SILBAGAN | Age | 17.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/60 mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||