Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05769 | Date 15/07/2019 |
| Token No | SM/19-20/7147 23/07/2019 | Serial | 085 Last Visit: 23/07/2019 |
| Patient Name | Mrs. NURAISHA BIBI | Contact No | 9874066615 |
| Address | 3 CHATRA MUSALMAN PARA | Age | 50 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 48 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||