Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07974 | Date 30/03/2020 |
| Token No | SM/19-20/20515 30/03/2020 | Serial | 066 Last Visit: 30/03/2020 |
| Patient Name | Mrs. FIROJA BIBI | Contact No | 9163750481 |
| Address | 37 MUSLIM PARA ROAD SHEORAPHULI | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||