Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03420 | Date 07/02/2019 |
| Token No | SM/18-19/8178 07/02/2019 | Serial | 005 Last Visit: 07/02/2019 |
| Patient Name | Mrs. SAIJADI KHATUN | Contact No | |
| Address | CHAPDANI BAZAR, | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||