Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10001 | Date 28/08/2021 |
| Token No | SM/21-22/4523 28/08/2021 | Serial | 005 Last Visit: 28/08/2021 |
| Patient Name | Mrs. REJINA BIBI | Contact No | 9831994489 |
| Address | 47 CHATRA MUSALMAN PARA | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||