Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01663 | Date 13/10/2018 |
| Token No | SM/18-19/2870 13/10/2018 | Serial | 024 Last Visit: 13/10/2018 |
| Patient Name | Mrs. MARJINA BIBI | Contact No | 8697098429 |
| Address | CHATRA KUMOR PARA | Age | 20 Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||