Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01558 | Date 08/01/2019 |
| Token No | SM/18-19/2570 22/02/2019 | Serial | 013 |
| Patient Name | Mrs. MARUFA BIBI | Contact No | 8420858665 |
| Address | 16 K. M SHA ST | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||