Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10003 | Date 28/08/2021 |
| Token No | SM/21-22/4532 28/08/2021 | Serial | 014 Last Visit: 28/08/2021 |
| Patient Name | Mrs. TASLIMA BIBI | Contact No | 9143202790 |
| Address | 47 CHATRA MUSALMAN PARA ROAD | Age | 29 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||