Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03066 | Date 18/01/2019 |
| Token No | SM/18-19/7033 18/01/2019 | Serial | 037 Last Visit: 18/01/2019 |
| Patient Name | Mrs. FEROJA BIBI | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 55 YES Female |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||