Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05241 | Date 27/05/2019 |
| Token No | SM/19-20/3474 27/05/2019 | Serial | 030 Last Visit: 28/06/2019 |
| Patient Name | Mrs. MORJINA BIBI | Contact No | 9674695710 |
| Address | CHATRA MUSALMAN PARA | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||