Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01594 | Date 10/10/2018 |
| Token No | SM/18-19/4324 28/11/2018 | Serial | 056 Last Visit: 28/11/2018 |
| Patient Name | Mrs. RAKIYA BEGAM | Contact No | 7890566460 |
| Address | CHATRA MUSALMAN PARA | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||