Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01089 | Date 13/09/2018 |
| Token No | SM/18-19/10355 11/03/2019 | Serial | 064 Last Visit: 21/06/2019 |
| Patient Name | Baby SABANA KHATUN | Contact No | |
| Address | 20 CHATRA MUSALMAN PARA | Age | 2 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||