Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01509 | Date 04/10/2018 |
| Token No | SM/18-19/2455 04/10/2018 | Serial | 053 Last Visit: 04/10/2018 |
| Patient Name | Mrs. ANJIRA KHATUN | Contact No | 8479954056 |
| Address | CAHATRA MUSALMAN PARA | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||