Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01567 | Date 09/10/2018 |
| Token No | SM/18-19/2617 09/10/2018 | Serial | 006 Last Visit: 09/10/2018 |
| Patient Name | Baby SAMRIN YASMIN KHATUN | Contact No | 8420357934 |
| Address | 7B CHATRA MUSALMAN PARA BY LANE | Age | 5 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||