Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02421 | Date 08/12/2018 |
| Token No | SM/18-19/4924 08/12/2018 | Serial | 051 Last Visit: 08/12/2018 |
| Patient Name | Mrs. SALIYA BIBI | Contact No | |
| Address | CHATRA MUSALAMAN PARA | Age | 70 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||