Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04104 | Date 08/03/2019 |
| Token No | SM/18-19/10209 08/03/2019 | Serial | 100 Last Visit: 08/03/2019 |
| Patient Name | Miss MASRUFA KHATUN | Contact No | 9836885000 |
| Address | CHATRA MUSAMAN PARA | Age | 9 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||