Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01510 | Date 04/10/2018 |
| Token No | SM/18-19/2456 04/10/2018 | Serial | 054 Last Visit: 04/10/2018 |
| Patient Name | Baby ALIYA KHATUN | Contact No | 8479954056 |
| Address | 12 CHATRA MUSALMAN PARA | Age | 3 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 11 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||