Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00712 | Date 27/08/2018 |
| Token No | SM/18-19/881 27/08/2018 | Serial | 014 Last Visit: 27/08/2018 |
| Patient Name | Mrs. RABINA KHATUN | Contact No | 7890084719 |
| Address | CHATRA ARABINDA SARANI | Age | 9.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||