Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01222 | Date 19/09/2018 |
| Token No | SM/18-19/1825 19/09/2018 | Serial | 037 Last Visit: 19/09/2018 |
| Patient Name | Mrs. AKSALINA BIBI | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 17 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||