Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01960 | Date 14/11/2018 |
| Token No | SM/18-19/4624 04/12/2018 | Serial | 010 Last Visit: 23/07/2019 |
| Patient Name | Mrs. NURJAHAN BIBI | Contact No | |
| Address | 33 CHATRA MUSALMAN PARA | Age | 29 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||