Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07190 | Date 19/12/2019 |
| Token No | SM/19-20/15603 19/12/2019 | Serial | 032 Last Visit: 19/12/2019 |
| Patient Name | Mrs. JANEB KHATUN | Contact No | 9150924825 |
| Address | 12 CHATRA MUSALMAN KUMAR PARA | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||