Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03550 | Date 13/02/2019 |
| Token No | SM/18-19/8587 13/02/2019 | Serial | 054 Last Visit: 13/02/2019 |
| Patient Name | Mrs. JAMILA KHATUN | Contact No | 9748777088 |
| Address | 18 JUTE MIL (QUT.) | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||