Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09936 | Date 12/08/2021 |
| Token No | SM/21-22/4005 12/08/2021 | Serial | 035 Last Visit: 12/08/2021 |
| Patient Name | Mrs. RUBINA BIBI | Contact No | 7890681416 |
| Address | 21 CHATRA MUSALMAN PARA BYE LANE | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||