Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02705 | Date 27/12/2018 |
| Token No | SM/18-19/6211 03/01/2019 | Serial | 048 Last Visit: 26/04/2022 |
| Patient Name | Mrs. FAKIRUN BIBI | Contact No | |
| Address | 18/1 CHATRA MUSALMAN PARA BY LANE | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||