Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 08768 | Date 22/09/2020 |
| Token No | SM/20-21/26575 12/10/2020 | Serial | 070 Last Visit: 12/10/2020 |
| Patient Name | Mrs. KHUSBU BIBI | Contact No | 9330222301 |
| Address | 12 CHATRA MUSALMAN PARA BYE LANE | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||