Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01416 | Date 29/09/2018 |
| Token No | SM/18-19/2230 29/09/2018 | Serial | 018 Last Visit: 05/04/2019 |
| Patient Name | Miss NAZNI KHATUN | Contact No | 7686829852 |
| Address | CHATRA MUSALMAN PARA | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||