Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00523 | Date 17/08/2018 |
| Token No | SM/18-19/6238 04/01/2019 | Serial | 023 Last Visit: 04/01/2019 |
| Patient Name | Mrs. NASIMA KHATOON | Contact No | |
| Address | 7, ARBINDO SARANI | Age | 24 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||