Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02036 | Date 19/11/2018 |
| Token No | SM/18-19/8760 15/02/2019 | Serial | 048 Last Visit: 15/02/2019 |
| Patient Name | Mrs. ASLEMA BIBI | Contact No | 9051867258 |
| Address | 83, MALLIK PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||