Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00129 | Date 04/08/2018 |
| Token No | SM/18-19/1164 01/09/2018 | Serial | 038 Last Visit: 01/09/2018 |
| Patient Name | Baby FARAH KHATUN | Contact No | |
| Address | CHATRA MUSALAMAN PARA | Age | 3.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||