Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06784 | Date 05/11/2019 |
| Token No | SM/19-20/14892 09/12/2019 | Serial | 002 Last Visit: 03/02/2020 |
| Patient Name | Mrs. SULTANA KHATOON | Contact No | 7439098615 |
| Address | 5/11 A.B ROAD RISHRA | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||