Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01585 | Date 09/10/2018 |
| Token No | SM/18-19/2658 09/10/2018 | Serial | 047 Last Visit: 09/10/2018 |
| Patient Name | Miss SAIMA KHATUN | Contact No | 9674452150 |
| Address | 47/B CHATRA MUSALMAN PARA | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||