Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01383 | Date 27/09/2018 |
| Token No | SM/19-20/2832 15/05/2019 | Serial | 072 Last Visit: 11/11/2019 |
| Patient Name | Mrs. SABITA BIBI | Contact No | 9830752588 |
| Address | CHATRA MUSALMAN PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||