Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06001 | Date 29/07/2019 |
| Token No | SM/19-20/7549 29/07/2019 | Serial | 085 Last Visit: 07/03/2020 |
| Patient Name | Mrs. JINNTUN BIBI | Contact No | 8017387597 |
| Address | 35 CHATRA MUSALMAN PARA | Age | 35 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||