Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01602 | Date 10/10/2018 |
| Token No | SM/18-19/3372 02/11/2018 | Serial | 056 Last Visit: 23/06/2025 |
| Patient Name | Miss MONOWARA KHATUN | Contact No | 9748931169 |
| Address | 33 MUSALMAN PARA BYE LANE CHATRA | Age | 13 Years,0 Months,6 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 13 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||