Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09144 | Date 08/01/2021 |
| Token No | SM/20-21/29181 08/01/2021 | Serial | 019 Last Visit: 05/03/2021 |
| Patient Name | Mrs. HASIDUN BIBI | Contact No | 6290918190 |
| Address | 21 MUSALMAN PARA BYE LANE ,CHATRA | Age | 20 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||