Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01831 | Date 01/11/2018 |
| Token No | SM/18-19/3284 01/11/2018 | Serial | 033 Last Visit: 01/11/2018 |
| Patient Name | Mrs. SULEKHA BIBI | Contact No | |
| Address | CHATRA MUSALMAN PARA / LANE | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||