Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02464 | Date 11/12/2018 |
| Token No | SM/18-19/7300 22/01/2019 | Serial | 071 Last Visit: 18/02/2019 |
| Patient Name | Mrs. SAHINA KHATUN | Contact No | |
| Address | SHIL BAGAN | Age | 37 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||