Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01104 | Date 13/09/2018 |
| Token No | SM/18-19/2127 27/09/2018 | Serial | 008 Last Visit: 04/10/2018 |
| Patient Name | Mrs. RUKSANA BIBI | Contact No | 8100239528 |
| Address | 41 PARSI LANE SILBAGAN | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||