Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05110 | Date 15/05/2019 |
| Token No | SM/19-20/2787 15/05/2019 | Serial | 027 Last Visit: 15/05/2019 |
| Patient Name | Mrs. SAPNA BIBI | Contact No | 8240213055 |
| Address | CHATRA MUSALMAN PARA | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||