Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01584 | Date 09/10/2018 |
| Token No | SM/18-19/2657 09/10/2018 | Serial | 046 Last Visit: 09/10/2018 |
| Patient Name | Miss RESHMA KHATUN | Contact No | 9674452150 |
| Address | 47/B CHATRA MUSALMAN PARA | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||