Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 01782 | Date 30/10/2018 |
| Token No | SM/18-19/3521 05/11/2018 | Serial | 081 Last Visit: 05/11/2018 |
| Patient Name | Miss AFRINA KHATUN | Contact No | |
| Address | CHATRA MUSALMAN PARA | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 36 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||