Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01385 | Date 27/09/2018 |
| Token No | SM/18-19/2437 04/10/2018 | Serial | 035 Last Visit: 04/10/2018 |
| Patient Name | Mrs. REHEMA BIBI | Contact No | |
| Address | SEORAPHULI FHOKIR PARA | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||