Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 02792 | Date 02/01/2019 |
| Token No | SM/18-19/8816 16/02/2019 | Serial | 040 Last Visit: 16/02/2019 |
| Patient Name | Mrs. SAFIYA BIBI | Contact No | |
| Address | 18 PARSI LANE SILBAGAN | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||