Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06773 | Date 31/10/2019 |
| Token No | SM/19-20/12545 31/10/2019 | Serial | 066 Last Visit: 31/10/2019 |
| Patient Name | Mrs. MEHRUN NISA | Contact No | |
| Address | 7 CHATRA KUMAR PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||