Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08263 | Date 16/05/2020 |
| Token No | SM/19-20/22288 16/05/2020 | Serial | 004 Last Visit: 05/06/2020 |
| Patient Name | Mrs. SUKHJAN KHATUN | Contact No | 8013546385 |
| Address | 20 CHATRA MUSALMAN PARA | Age | 33 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||