Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00702 | Date 25/08/2018 |
| Token No | SM/19-20/11053 24/09/2019 | Serial | 071 Last Visit: 24/09/2019 |
| Patient Name | Mrs. GULAFSA KHATUN | Contact No | 7890681416 |
| Address | 5/C CHATRA MUSALMANPARA /LANE | Age | 24.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||