Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01541 | Date 05/10/2018 |
| Token No | SM/18-19/6907 16/01/2019 | Serial | 053 Last Visit: 16/01/2019 |
| Patient Name | Mrs. ROZINA KHATUN | Contact No | 8697436686 |
| Address | CHATRA KUMAR PARA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||