Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02265 | Date 01/12/2018 |
| Token No | SM/18-19/4494 01/12/2018 | Serial | 021 Last Visit: 11/05/2020 |
| Patient Name | Baby SUHANA KHATUN | Contact No | 7890681416 |
| Address | 5/C CHATRA MUSALMAN PARA BY LANE | Age | 3 Y 8 M Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 12 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||