Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08175 | Date 30/04/2020 |
| Token No | SM/19-20/21740 30/04/2020 | Serial | 024 Last Visit: 30/04/2020 |
| Patient Name | Mrs. AYESHA BIBI | Contact No | 9123921418 |
| Address | CHATRA KUMOR PARA | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||