Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03440 | Date 07/02/2019 |
| Token No | SM/20-21/26298 05/10/2020 | Serial | 034 Last Visit: 05/10/2020 |
| Patient Name | Mrs. MARUFA BIBI | Contact No | |
| Address | 8 CHATRA MUSALMAN PARA | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||