Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01090 | Date 13/09/2018 |
| Token No | SM/18-19/9641 01/03/2019 | Serial | 016 Last Visit: 01/03/2019 |
| Patient Name | Mrs. JAHORA KHATUN | Contact No | 7044611156 |
| Address | 7, ARBINDA SARNI | Age | 35.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||