Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00606 | Date 21/08/2018 |
| Token No | SM/21-22/5900 08/10/2021 | Serial | 022 Last Visit: 20/08/2025 |
| Patient Name | Mrs. SULTANA BIBI | Contact No | 9007733611 |
| Address | 9, CHATRA ARBINDO SARNI | Age | 30 Years,7 Months,18 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||