Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 05753 | Date 13/07/2019 |
| Token No | SM/19-20/6390 13/07/2019 | Serial | 054 Last Visit: 13/07/2019 |
| Patient Name | Mrs. ASGARI KHATUN | Contact No | 8013252565 |
| Address | 10 KANAI DEWAN TALA, | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||