Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03295 | Date 01/02/2019 |
| Token No | SM/18-19/7803 01/02/2019 | Serial | 079 Last Visit: 01/02/2019 |
| Patient Name | Mrs. SAYRA BEGAM | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||