Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07483 | Date 05/02/2020 |
| Token No | SM/19-20/17670 05/02/2020 | Serial | 046 Last Visit: 05/02/2020 |
| Patient Name | Mrs. AYASA BIBI | Contact No | 9163332922 |
| Address | 3/A CHATRA MUSALMAN PARA | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||