Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05721 | Date 10/07/2019 |
| Token No | SM/19-20/6219 10/07/2019 | Serial | 087 Last Visit: 10/07/2019 |
| Patient Name | Mrs. ANNA BIBI | Contact No | |
| Address | CHATRA KUMARPARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||