Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03141 | Date 22/01/2019 |
| Token No | SM/18-19/7289 22/01/2019 | Serial | 060 Last Visit: 16/03/2019 |
| Patient Name | Mrs. NABHAR BIBI | Contact No | |
| Address | 18 CHATRA MUSALMAN PARA | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||