Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01212 | Date 19/09/2018 |
| Token No | SM/18-19/1804 19/09/2018 | Serial | 016 Last Visit: 19/09/2018 |
| Patient Name | Mrs. RAMISA BIBI | Contact No | 7450965951 |
| Address | CHATRA MUSALMAN PARA BYE LANE | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/80 mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||