Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03032 | Date 16/01/2019 |
| Token No | SM/18-19/6914 16/01/2019 | Serial | 060 Last Visit: 16/01/2019 |
| Patient Name | Mrs. RUKSANA BIBI | Contact No | 8956144382 |
| Address | MALLICK PARA MIYAJEN DARJI LANE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||