Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01474 | Date 03/10/2018 |
| Token No | SM/18-19/2374 03/10/2018 | Serial | 029 Last Visit: 03/10/2018 |
| Patient Name | Baby SULTANA KHATUN | Contact No | 9088843088 |
| Address | CHATRA MUSALMAN PARA | Age | 2 YRS 5 MNTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||