Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00510 | Date 17/08/2018 |
| Token No | SM/18-19/579 17/08/2018 | Serial | 017 Last Visit: 17/08/2018 |
| Patient Name | Mrs. TINA KHAN | Contact No | |
| Address | 23/A BAGER BAGAN CHATRA | Age | 4.6 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||