Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04583 | Date 05/04/2019 |
| Token No | SM/19-20/372 05/04/2019 | Serial | 078 Last Visit: 08/04/2019 |
| Patient Name | Mrs. NASIMA KHATUN | Contact No | |
| Address | 12CHATRA MUSALMAN PARA | Age | 25 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||