Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09168 | Date 13/01/2021 |
| Token No | SM/20-21/29324 13/01/2021 | Serial | 047 Last Visit: 13/01/2021 |
| Patient Name | Mrs. ASURA BIBI | Contact No | 9592845854 |
| Address | 54/2 MUSALMANA PARA BYE LANE | Age | 63 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||