Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01657 | Date 13/10/2018 |
| Token No | SM/18-19/2857 13/10/2018 | Serial | 011 Last Visit: 13/10/2018 |
| Patient Name | Mrs. FARIDA BIBI | Contact No | 8910716292 |
| Address | CHATRA KUMARPARA | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | 100/70 / min | Height | cm BMI: inf |
| Diagnosis | |||