Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01199 | Date 18/09/2018 |
| Token No | SM/18-19/4698 05/12/2018 | Serial | 022 Last Visit: 05/12/2018 |
| Patient Name | Mrs. SANJIDA BIBI | Contact No | 9903525847 |
| Address | CHTRA MUSALMAN PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||