Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01884 | Date 03/11/2018 |
| Token No | SM/18-19/3433 03/11/2018 | Serial | 046 Last Visit: 03/11/2018 |
| Patient Name | Mrs. JANISHA BIBI | Contact No | 9874876616 |
| Address | 18/1CHATRA MUSALMAN PARA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||