Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02266 | Date 01/12/2018 |
| Token No | SM/18-19/4496 01/12/2018 | Serial | 023 Last Visit: 01/12/2018 |
| Patient Name | Mrs. GULABSA KHATUN | Contact No | 7890681416 |
| Address | 5/C CHATRA MUSALMAN PARA | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||