Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01997 | Date 16/11/2018 |
| Token No | SM/18-19/5032 11/12/2018 | Serial | 012 Last Visit: 11/12/2018 |
| Patient Name | Miss SABINA KHATUN | Contact No | 9874463025 |
| Address | 50 CHATRA MUSALMAN PARA | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||