Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06665 | Date 16/10/2019 |
| Token No | SM/19-20/11884 16/10/2019 | Serial | 102 Last Visit: 15/09/2020 |
| Patient Name | Mrs. AJMIRA BIBI | Contact No | 8479953925 |
| Address | 4/A CHATRA MUSALMAN PARA LANE | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||