Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00556 | Date 18/08/2018 |
| Token No | SM/18-19/650 18/08/2018 | Serial | 046 Last Visit: 18/08/2018 |
| Patient Name | Mrs. RUBINA KHATOON | Contact No | 8820186193 |
| Address | CHATRA MUSALMAN PARA | Age | 10.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||