Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01097 | Date 13/09/2018 |
| Token No | SM/18-19/3887 19/11/2018 | Serial | 054 Last Visit: 18/08/2025 |
| Patient Name | Mrs. CHAYNA BIBI | Contact No | 7890728153 |
| Address | CHATRA MUSALMAN PARA | Age | 62 Years,7 Months,16 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||