Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04571 | Date 05/04/2019 |
| Token No | SM/19-20/335 05/04/2019 | Serial | 041 Last Visit: 03/05/2019 |
| Patient Name | Mrs. AMINA BIBI | Contact No | 9831885141 |
| Address | 7 CHATRA KUMER PARA | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||