Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05761 | Date 13/07/2019 |
| Token No | SM/19-20/6427 13/07/2019 | Serial | 091 Last Visit: 13/07/2019 |
| Patient Name | Mrs. ASHURA KHATUN | Contact No | 9674112007 |
| Address | 21 CHATRA KUMER PARA | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||