Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09161 | Date 13/01/2021 |
| Token No | SM/20-21/29289 13/01/2021 | Serial | 012 Last Visit: 13/01/2021 |
| Patient Name | Mrs. SAHANARA KHATUN | Contact No | 9592845854 |
| Address | 5A/2 CHATRA MUSALMAN PARA BYE LANE | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||