Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01857 | Date 02/11/2018 |
| Token No | SM/18-19/3348 02/11/2018 | Serial | 032 Last Visit: 14/11/2018 |
| Patient Name | Mrs. FIROJA KHATUN | Contact No | |
| Address | BARO BELUR KAL TALA | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 120/80 mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||