Ticket for Outdoor Patient
| Ward No. | U-PHC No. | Registration No. 00196 | Date 07/08/2018 |
| Token No | SM/18-19/203 07/08/2018 | Serial | 018 Last Visit: 07/08/2018 |
| Patient Name | Baby SANAYA KHATUN | Contact No | |
| Address | PANDUA | Age | 3.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||