Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02091 | Date 22/11/2018 |
| Token No | SM/18-19/4047 22/11/2018 | Serial | 042 Last Visit: 22/11/2018 |
| Patient Name | Mrs. JHUMA KHATUN | Contact No | 7044948498 |
| Address | CHATRA MUSALMAN PRA | Age | 23 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||