Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02478 | Date 12/12/2018 |
| Token No | SM/18-19/5361 17/12/2018 | Serial | 042 Last Visit: 02/07/2019 |
| Patient Name | Mrs. ASMA KHATUN | Contact No | 7450872597 |
| Address | CHATRA MUSALMAN PARA | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||