Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01741 | Date 29/10/2018 |
| Token No | SM/18-19/3732 15/11/2018 | Serial | 027 Last Visit: 15/11/2018 |
| Patient Name | Miss NOORJAHA KAHTUN | Contact No | 9748284723 |
| Address | 24, PARSI LANE SILBAGAN | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 32 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||