Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05967 | Date 26/07/2019 |
| Token No | SM/19-20/7377 26/07/2019 | Serial | 046 Last Visit: 26/07/2019 |
| Patient Name | Mrs. FAJANA BIBI | Contact No | 9748249014 |
| Address | 33/A CHATRA MUSALMAN PARA | Age | 25 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||