Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03114 | Date 21/01/2019 |
| Token No | SM/18-19/7182 21/01/2019 | Serial | 050 Last Visit: 12/06/2019 |
| Patient Name | Mrs. MINA BIBI | Contact No | 8100415611 |
| Address | 28 SILEKHANA ROAD MALLIK PARA | Age | 47 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 180/100 mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||