Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04470 | Date 29/03/2019 |
| Token No | SM/18-19/11584 29/03/2019 | Serial | 092 Last Visit: 29/03/2019 |
| Patient Name | Baby SABINA KHATUN | Contact No | 8617274181 |
| Address | 21 CHATRA MUSALMAN PARA | Age | 3 Y Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||