Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04984 | Date 30/04/2019 |
| Token No | SM/19-20/2030 02/05/2019 | Serial | 001 Last Visit: 17/12/2025 |
| Patient Name | Mrs. NOORMAHAN BIBI | Contact No | 7450878995 |
| Address | CHATRA MUSALMAN PARA | Age | 52 Years,11 Months,15 Days Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||