Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02178 | Date 28/11/2018 |
| Token No | SM/18-19/4712 05/12/2018 | Serial | 036 Last Visit: 05/09/2025 |
| Patient Name | Mrs. MAIRUM BIBI | Contact No | 7439097593 |
| Address | 34CHATRA MUSALMAN PARA | Age | 38 Years,8 Months,4 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||