Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 11968 | Date 13/03/2023 |
| Token No | SM/22-23/20611 13/03/2023 | Serial | 028 Last Visit: 13/03/2023 |
| Patient Name | Mrs. KULSUMA KHATUN | Contact No | 7679925917 |
| Address | 47 CHATRA MUSALMAN PARA ROAD | Age | 15 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||