Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 01028 | Date 10/09/2018 |
| Token No | SM/20-21/25935 22/09/2020 | Serial | 031 Last Visit: 22/09/2020 |
| Patient Name | Mrs. TABSUM KHATUN | Contact No | 9339742590 |
| Address | 11A PARSHI LANE,SHIL BAGAN | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||