Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02535 | Date 14/12/2018 |
| Token No | SM/18-19/5262 14/12/2018 | Serial | 051 Last Visit: 14/12/2018 |
| Patient Name | Mrs. HASIDA BIBI | Contact No | 9874876616 |
| Address | 21 CHATRA MUSALMAN PARA | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||