Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 03812 | Date 22/02/2019 |
| Token No | SM/18-19/9308 22/02/2019 | Serial | 085 Last Visit: 11/03/2019 |
| Patient Name | Mrs. SABNAM BIBI | Contact No | 8231879979 |
| Address | CHATRA MUSALMAN PARA | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||