Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01202 | Date 19/09/2018 |
| Token No | SM/18-19/1789 19/09/2018 | Serial | 001 Last Visit: 19/09/2018 |
| Patient Name | Mrs. MONOWARA BIBI | Contact No | 9830681972 |
| Address | 1,MALLICKPARA SILEKHALA ROAD | Age | 40 Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||