Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02015 | Date 16/11/2018 |
| Token No | SM/18-19/3821 16/11/2018 | Serial | 054 Last Visit: 19/12/2018 |
| Patient Name | Mrs. GULABSA KHATUN | Contact No | 9903710038 |
| Address | CHATRA MUSALMAN PARA | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||