Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01721 | Date 27/10/2018 |
| Token No | SM/18-19/3014 27/10/2018 | Serial | 063 Last Visit: 27/10/2018 |
| Patient Name | Baby HASINA KHATUN | Contact No | 9874876616 |
| Address | CHATRA MUSALMAN PARA | Age | 1.6 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 9 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||