Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01704 | Date 27/10/2018 |
| Token No | SM/18-19/2990 27/10/2018 | Serial | 039 Last Visit: 14/11/2018 |
| Patient Name | Baby TAMANNA KHATUN | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 2 Y 6 MAN Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||