Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01611 | Date 10/10/2018 |
| Token No | SM/18-19/2725 10/10/2018 | Serial | 050 Last Visit: 10/10/2018 |
| Patient Name | Mrs. SULTANA KHATUN | Contact No | 9804405515 |
| Address | CHATRA MUSALMAN PARA BY LANE | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||