Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02924 | Date 09/01/2019 |
| Token No | SM/18-19/6555 09/01/2019 | Serial | 044 Last Visit: 09/01/2019 |
| Patient Name | Miss SHAGUFHA SHAHEEN | Contact No | 9748858660 |
| Address | 16 RABINDRA BHABAN ROAD | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||