Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01985 | Date 15/11/2018 |
| Token No | SM/18-19/3744 15/11/2018 | Serial | 039 Last Visit: 07/01/2019 |
| Patient Name | Mrs. HUSANARA KHATUN | Contact No | |
| Address | BORO BELUR KALTALA | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||