Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04606 | Date 08/04/2019 |
| Token No | SM/19-20/464 08/04/2019 | Serial | 028 Last Visit: 08/04/2019 |
| Patient Name | Mrs. SURPAN BIBI | Contact No | 9831236433 |
| Address | 1 CHATRA MUSAL MAN PARA BYE LANE | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||