Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01274 | Date 22/09/2018 |
| Token No | SM/18-19/1937 22/09/2018 | Serial | 050 Last Visit: 22/09/2018 |
| Patient Name | Mrs. BASSHA KHATUN | Contact No | 8697098429 |
| Address | CHATRA KUMARPARA | Age | 12 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 33 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||