Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03169 | Date 24/01/2019 |
| Token No | SM/18-19/7403 24/01/2019 | Serial | 090 Last Visit: 24/01/2019 |
| Patient Name | Mrs. MUSARAT BIBI | Contact No | 7278658022 |
| Address | 7/D ARBINDA SARANI | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||