Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 01176 | Date 15/09/2018 |
| Token No | SM/18-19/8767 15/02/2019 | Serial | 055 Last Visit: 15/02/2019 |
| Patient Name | Mrs. SAGUFTA ZABI | Contact No | 7449890744 |
| Address | 45/A N.N RAY STREET | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||