Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01113 | Date 13/09/2018 |
| Token No | SM/21-22/7482 06/12/2021 | Serial | 001 Last Visit: 06/12/2021 |
| Patient Name | Mrs. SAJIMA KHATUN | Contact No | |
| Address | CHATRA KUMAR PARA | Age | 18.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||