Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01710 | Date 27/10/2018 |
| Token No | SM/18-19/3001 27/10/2018 | Serial | 050 Last Visit: 27/10/2018 |
| Patient Name | Miss RASNI PARVHIN | Contact No | |
| Address | CHATRA MUSALMAN PARS | Age | 8 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||