Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06619 | Date 14/10/2019 |
| Token No | SM/19-20/12518 31/10/2019 | Serial | 039 Last Visit: 06/08/2020 |
| Patient Name | Mrs. LAYALUNA BIBI | Contact No | 9038164940 |
| Address | 29/A CHATRA MUSALMAN PARA,SHEORAPHULI | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 52 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||