Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00910 | Date 04/09/2018 |
| Token No | SM/18-19/2278 29/09/2018 | Serial | 066 Last Visit: 13/03/2019 |
| Patient Name | Mrs. HASINA BIBI | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||