Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06421 | Date 16/09/2019 |
| Token No | SM/19-20/10543 17/09/2019 | Serial | 034 Last Visit: 17/09/2019 |
| Patient Name | Mrs. AMINA BIBI (KHATUN) | Contact No | 9051945424 |
| Address | 29/C CHATRA MUSALMAN PARA BYE LANE | Age | 19 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||