Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01464 | Date 01/10/2018 |
| Token No | SM/18-19/2336 01/10/2018 | Serial | 056 Last Visit: 16/03/2019 |
| Patient Name | Miss AFRIN KHATUN | Contact No | 8444979212 |
| Address | 7/A ARBINDA SARANI | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||