Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01454 | Date 01/10/2018 |
| Token No | SM/18-19/2320 01/10/2018 | Serial | 040 Last Visit: 04/10/2018 |
| Patient Name | Mrs. FOJILA BIBI | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 90/60 mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||